Melis G B, Fruzzetti F, Nicoletti I, Ricci C, Lammers P, Atsma W J, Fioretti P
Department of Obstetrics and Gynecology, University of Pisa, Italy.
Contraception. 1991 Jan;43(1):23-31. doi: 10.1016/0010-7824(91)90123-w.
The changes in haemostasis during oral contraception are related to the ethinylestradiol dose present in the formulation taken by the patient. An open, randomized longitudinal study was performed to evaluate and compare the effects that low-dose oral contraceptives (OCs) containing different doses of ethinylestradiol exert on the haemostatic system. Eighty-nine healthy women, aged 18-45 years, were randomly assigned to treatment with 3 different OCs: a monophasic pill containing 30 micrograms of ethinylestradiol plus 75 micrograms of gestodene (GSD/30) (30 subjects), a triphasic pill containing levonorgestrel (TRI/LNG) (28 subjects), a monophasic pill containing 20 micrograms ethinylestradiol plus 150 micrograms of desogestrel (DOG/20) (31 subjects). From every woman, blood samples were collected before treatment and at the 3rd and 6th cycle of pill intake. The number of platelets significantly increased (p less than 0.01) during treatment with TRI/LNG. Fibrinogen plasma values were significantly increased (p less than 0.05) only in women treated with the preparation GSD/30. Fibrinopeptide A (FPA) plasma levels significantly increased (p less than 0.01) during treatment with the pills TRI/LNG and GSD/30, but the levels of FPA were unchanged in the group treated with DOG/20. The overall results of this study confirm that the effects of OCs on haemostasis are dependent on the ethinylestradiol dose. Moreover, they suggest that with reduction of the ethinylestradiol component to 20 micrograms, the effects of OCs on haemostasis seem to be virtually eliminated.
口服避孕药期间止血功能的变化与患者所服用制剂中炔雌醇的剂量有关。开展了一项开放性随机纵向研究，以评估和比较含有不同剂量炔雌醇的低剂量口服避孕药（OCs）对止血系统的影响。89名年龄在18至45岁之间的健康女性被随机分配接受3种不同OCs的治疗：一种含有30微克炔雌醇加75微克孕二烯酮（GSD/30）的单相药丸（30名受试者），一种含有左炔诺孕酮的三相药丸（TRI/LNG）（28名受试者），一种含有20微克炔雌醇加150微克去氧孕烯（DOG/20）的单相药丸（31名受试者）。在每位女性治疗前以及服药的第3个和第6个周期采集血样。在使用TRI/LNG治疗期间，血小板数量显著增加（p<0.01）。仅在接受GSD/30制剂治疗的女性中，血浆纤维蛋白原值显著增加（p<0.05）。在使用TRI/LNG和GSD/30药丸治疗期间，血浆纤维蛋白肽A（FPA）水平显著增加（p<0.01），但在接受DOG/20治疗的组中FPA水平未发生变化。这项研究的总体结果证实，OCs对止血的影响取决于炔雌醇的剂量。此外，研究结果表明，随着炔雌醇成分降至20微克，OCs对止血的影响似乎几乎消除。
