Yamamoto H, Noguchi S, Miyauchi K, Inaji H, Imaoka S, Koyama H, Iwanaga T
Department of Surgery, Center for Adult Diseases, Osaka.
Jpn J Cancer Res. 1991 Apr;82(4):420-5. doi: 10.1111/j.1349-7006.1991.tb01865.x.
To elucidate the etiology of the thrombogenic effects of high-dose medroxyprogesterone acetate (MPA) in the treatment of breast cancer, hematologic parameters were sequentially assessed in 12 patients receiving MPA 800 mg p.o. daily for 6 months as adjuvant hormone therapy after mastectomy. The results were as follows. (1) Coagulation system: levels of factor VII and fibrinogen decreased significantly, whereas factors II and IX increased significantly, with a shortened activated partial thromboplastin time. (2) Fibrinolytic system: plasminogen and alpha 2-plasmin inhibitor-plasmin complex increased, whereas fibrinogen degradation products remained low. (3) Anticoagulation system: antithrombin III increased significantly. (4) These changes were most marked after 2 or 4 weeks of MPA treatment, and returned to the pretreatment level one month after discontinuation of treatment. (5) No patients in this study developed thromboembolic disease during or after MPA administration. These results indicate that MPA may induce a hypercoagulable state, but this state does not directly lead to the development of thrombosis.
为阐明大剂量醋酸甲羟孕酮（MPA）治疗乳腺癌时血栓形成作用的病因，对12例在乳房切除术后接受MPA每日口服800mg共6个月作为辅助激素治疗的患者，依次进行了血液学参数评估。结果如下：（1）凝血系统：Ⅶ因子和纤维蛋白原水平显著降低，而Ⅱ因子和Ⅸ因子显著升高，活化部分凝血活酶时间缩短。（2）纤溶系统：纤溶酶原和α2-纤溶酶抑制物-纤溶酶复合物增加，而纤维蛋白原降解产物仍保持在低水平。（3）抗凝系统：抗凝血酶Ⅲ显著增加。（4）这些变化在MPA治疗2周或4周后最为明显，停药1个月后恢复到治疗前水平。（5）本研究中无患者在MPA给药期间或之后发生血栓栓塞性疾病。这些结果表明，MPA可能诱导高凝状态，但这种状态不会直接导致血栓形成。
