Nightingale A L, Lawrenson R A, Simpson E L, Williams T J, MacRae K D, Farmer R D
Department of Pharmacoepidemiology and Primary Care, Postgraduate Medical School, University of Surrey, Guildford, UK.
Eur J Contracept Reprod Health Care. 2000 Dec;5(4):265-74. doi: 10.1080/13625180008500402.
To investigate the factors associated with idiopathic venous thromboembolism in combined oral contraceptive users and to estimate the crude and age-specific incidence rates ofidiopathic venous thromboembolism among this population.
The UK MediPlus Database and the General Practice Research Database were searched to identify women with evidence of venous thromboembolism while exposed to combined oral contraceptives. Cohort and nested case-control studies were carried out using the same methodology on both databases. We conducted a meta-analysis using the individual data for the cases and controls from the two case-control studies to identify factors associated with idiopathic venous thromboembolism in women using combined oral contraceptives.
The incidence rate of idiopathic venous thromboembolism among oral contraceptive users was 39.4 per 100,000 exposed woman-years. The age-specific incidence rates were found to rise sharply after the age of 39 years. Factors identified as being significantly associated with idiopathic venous thromboembolism in women using combined oral contraceptives were: body mass index of 25 kg/m2 and over, the association rising dramatically in women with a body mass index of 35 kg/m2 or more; smoking; general ill health; and asthma.
We believe that, before prescribing combined oral contraceptives, the venous as well as the arterial factors need to be considered and, in addition, age, obesity and smoking are all relevant when assessing an individual patient's risk.
调查复方口服避孕药使用者特发性静脉血栓栓塞的相关因素，并估算该人群特发性静脉血栓栓塞的粗发病率和年龄特异性发病率。
检索英国MediPlus数据库和全科医疗研究数据库，以确定在使用复方口服避孕药期间有静脉血栓栓塞证据的女性。对两个数据库采用相同方法进行队列研究和巢式病例对照研究。我们对两项病例对照研究中病例和对照的个体数据进行荟萃分析，以确定复方口服避孕药使用者特发性静脉血栓栓塞的相关因素。
口服避孕药使用者中特发性静脉血栓栓塞的发病率为每100,000暴露女性年39.4例。发现年龄特异性发病率在39岁以后急剧上升。确定与复方口服避孕药使用者特发性静脉血栓栓塞显著相关的因素为：体重指数25kg/m2及以上，体重指数35kg/m2或更高的女性中该关联显著增加；吸烟；总体健康状况不佳；以及哮喘。
我们认为，在开具复方口服避孕药之前，需要考虑静脉和动脉因素，此外，在评估个体患者风险时，年龄、肥胖和吸烟均与之相关。
