Weiss Claus, Walter Birgit, Dorsch Micha F, Bärtsch Peter
Department of Internal Medicine VII/Sportsmedicine, University Hospital Heidelberg, Germany.
Blood Coagul Fibrinolysis. 2006 Oct;17(7):563-8. doi: 10.1097/01.mbc.0000245301.10387.83.
The use of oral contraceptives (OC) is associated with an increased risk of thrombosis, suggesting OC exert procoagulant and/or antifibrinolytic effects. Given that physical exercise physiologically leads to an activation of blood coagulation and fibrinolysis, this study tested the hypothesis that OC might compromise the fibrinolytic response to exercise. Fibrinolytic variables were measured in 10 women (24 +/- 2 years) using OC (a formulation containing 30 micro g ethinylestradiol and 150 micro g desogestrel) and in 11 women without OC (mean +/- SD, 27 +/- 3 years) before, during and after a 1-h run on a treadmill at a velocity corresponding to an oxygen demand of 75-80% of maximum (anaerobic threshold). Exercise testing gave rise to considerable increases of tissue-type plasminogen activator antigen by seven-fold to eight-fold in women taking and not taking OC alike. In the presence of unchanged plasma levels of plasminogen activator inhibitor-1, exercise-induced release of tissue-type plasminogen activator led to enhanced plasmin formation with respect to plasmin-antiplasmin complexes, rising by (mean +/- standard error) 701 +/- 77 ng/ml (P < 0.001) in women using OC and by 695 +/- 117 ng/ml (P < 0.001 versus baseline; NS versus OC users) in controls. The fibrinolytic response to intensive physical exercise is preserved in women using OC and is similar to women not using OC.
口服避孕药(OC)的使用与血栓形成风险增加相关,提示OC具有促凝血和/或抗纤维蛋白溶解作用。鉴于体育锻炼在生理上会导致凝血和纤维蛋白溶解的激活,本研究检验了OC可能会损害运动引起的纤维蛋白溶解反应这一假设。在10名使用OC(一种含有30μg炔雌醇和150μg去氧孕烯的制剂)的女性(24±2岁)和11名未使用OC的女性(平均±标准差,27±3岁)中,于在跑步机上以相当于最大需氧量75 - 80%(无氧阈值)的速度进行1小时跑步之前、期间和之后,测量纤维蛋白溶解变量。运动测试使服用和未服用OC的女性的组织型纤溶酶原激活物抗原均显著增加了7至8倍。在血浆纤溶酶原激活物抑制剂-1水平不变的情况下,运动诱导的组织型纤溶酶原激活物释放导致相对于纤溶酶 - 抗纤溶酶复合物的纤溶酶形成增强,使用OC的女性中升高了(平均±标准误)701±77 ng/ml(P < 0.001),对照组中升高了695±117 ng/ml(与基线相比P < 0.001;与使用OC的女性相比无显著差异)。使用OC的女性对剧烈体育锻炼的纤维蛋白溶解反应得以保留,且与未使用OC的女性相似。