Vandenbroucke J P
Departement Klinische Epidemiologie, Leids Universitair Medisch Centrum, PO Box 9600, 2300 RC Leiden, Nederland.
Verh K Acad Geneeskd Belg. 2001;63(3):243-52; discussion 252-5.
"The pill" (oral contraception) is one of the most frequently used and efficient means of birth control. The pill was developed in the middle of the 1950s, and was prescribed in Europe from the early sixties onwards. Because millions of healthy young women in industrialized societies use oral contraceptives, even rare side effects receive a lot of attention. In the early 1960s "the pill" was associated with an increased frequency of arterial and venous thrombosis. However rare, these findings often engendered strong controversies. One of the reasons thereof was the uncertainty about the mechanism: it was not understood how the pill could cause an increased tendency towards thrombosis. In the past 5 years, epidemiologic, haemostatic and clinical research has led to new insights in how "the pill" causes venous thrombosis. These developments followed the discovery of "Activated protein C resistance" and the factor V Leiden mutation. The developments were accelerated by the finding that "third generation oral contraceptives" are associated with a higher risk of venous thrombosis. The lecture describes these new scientific insights.
“避孕药”（口服避孕药）是最常用且有效的节育手段之一。避孕药于20世纪50年代中期研发出来，从60年代初开始在欧洲投入使用。由于工业化社会中数以百万计的健康年轻女性使用口服避孕药，即便罕见的副作用也备受关注。20世纪60年代初，“避孕药”与动脉和静脉血栓形成频率增加有关。尽管这些发现很罕见，但常常引发激烈争议。其中一个原因是机制不明：人们不明白避孕药是如何导致血栓形成倾向增加的。在过去5年里，流行病学、止血和临床研究使人们对“避孕药”如何导致静脉血栓形成有了新的认识。这些进展是在发现“活化蛋白C抵抗”和凝血因子V莱顿突变之后取得的。“第三代口服避孕药”与静脉血栓形成风险较高有关这一发现加速了这些进展。本次讲座将介绍这些新的科学见解。
