Ferreira A C, Montes M B, Franceschini S A, Toloi M R
Department of Clinical, Toxicological and Bromatological Analysis, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Brazil.
Int J Fertil Womens Med. 2001 Sep-Oct;46(5):265-70.
Blood coagulation and fibrinolytic variables were evaluated in 46 Brazilian women treated with either of two monophasic oral contraceptives (OC), containing 30 or 20 microg of ethinyl estradiol, and 75 microg of gestodene.
The effects on procoagulants, anticoagulants, pro-fibrinolytics and antifibrinolytics and fibrin turnover were evaluated after treatment for six consecutive cycles, the impact of reduction of ethinyl estradiol dosage on these effects being assessed.
The OC containing 30 microg of ethinyl estradiol significantly increased the activities of factors VIII and X, whereas the one containing 20 microg of ethinyl estradiol caused no changes in clotting factors. Neither treatment altered fibrinogen levels or factor VII, IX or XII activity. There were no changes in antithrombin levels, but treatment with 30 microg ethinyl estradiol increased protein C levels and treatment with 20 microg decreased total protein S levels. Concerning the fibrinolytic parameters, both OCs increased plasminogen activity, whereas no changes in PAI-1, t-PA, alpha-2-antiplasmin or fibrin degradation products were observed. The reduction in ethinyl estradiol dosage from 30 microg to 20 microg eliminated the effects on factors VIII and X.
The results show that the OC studied did not cause sufficient changes to indicate that there may be a correlation between these laboratory alterations and clinical results. The lack of reports concerning the hemostatic effects of OCs on Brazilian women hinders comparison of the present data with those obtained for other ethnic groups, at different geographical locations, and emphasizes the importance of such a study for future epidemiological investigation of the prothrombotic effects of OCs in Brazilian women.
对46名巴西女性进行评估，这些女性使用了两种单相口服避孕药（OC）中的一种进行治疗，这两种避孕药分别含有30微克或20微克炔雌醇以及75微克孕二烯酮。
在连续治疗六个周期后，评估对促凝血剂、抗凝剂、促纤溶剂和抗纤溶剂以及纤维蛋白周转的影响，并评估炔雌醇剂量减少对这些影响的作用。
含有30微克炔雌醇的OC显著增加了因子VIII和X的活性，而含有20微克炔雌醇的OC对凝血因子没有影响。两种治疗均未改变纤维蛋白原水平或因子VII、IX或XII的活性。抗凝血酶水平没有变化，但使用30微克炔雌醇治疗可增加蛋白C水平，使用20微克治疗可降低总蛋白S水平。关于纤溶参数，两种OC均增加了纤溶酶原活性，而未观察到PAI-1、t-PA、α-2-抗纤溶酶或纤维蛋白降解产物有变化。炔雌醇剂量从30微克降至20微克消除了对因子VIII和X的影响。
结果表明，所研究的OC没有引起足够的变化，表明这些实验室改变与临床结果之间可能存在相关性。缺乏关于OC对巴西女性止血作用的报道阻碍了将本数据与在不同地理位置获得的其他种族的数据进行比较，并强调了此类研究对未来巴西女性OC促血栓形成作用的流行病学调查的重要性。
