Jensen Jeffrey T, Burke Anne E, Barnhart Kurt T, Tillotson Carrie, Messerle-Forbes Marci, Peters Dawn
Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR 97239, USA.
Contraception. 2008 Dec;78(6):451-8. doi: 10.1016/j.contraception.2008.07.004. Epub 2008 Aug 28.
The study was conducted to determine the impact of switching from oral to transdermal patch or vaginal ring contraception on biomarkers of thrombosis.
Current healthy oral contraceptive (OC) users were randomized to switch to either a contraceptive ring (CR) or patch (CP) and underwent phlebotomy to measure surrogate biomarkers of thrombosis [sex hormone-binding globulin (SHBG), free protein S and activated protein C resistance (APC-r)] before switching, and during the fourth cycle of use of the new method.
Of 142 reproductive age women enrolled, 120 sample pairs were available for analysis. SHBG increased significantly from baseline in CP users [mean change (95% CI), +29.9 nM (9.6-50)] but not in CR users [-1.6 (-16.6 to 13.5)]. Protein S decreased significantly from baseline in CP users [mean change -7.1% (-12.1 to -2.1)], but increased significantly in CR users [+5.3% (1.1-9.6)]. The APC-r ratio did not undergo a significant change from baseline in either group [CP +0.06 (-0.06 to 0.18), CR +0.02 (-0.10 to 0.14)]. Compared to CR users, subjects using the CP had significantly higher SHBG [187.5 (167.0-208), 146 (132.6-159.4), p=.012], significantly lower protein S [81.8 (76.8-86.8), 93.6 (89.1-98.1), p=.001] and similar APC-r ratios [2.99 (2.85-3.14), 3.09 (2.96, 3.22), p=.3] at the Cycle 4 visit.
OC users who switch to the ring exhibit beneficial changes in biomarkers of thrombosis, while those switching to the patch display a shift favoring clot formation.
本研究旨在确定从口服避孕药转换为透皮贴剂或阴道环避孕对血栓形成生物标志物的影响。
当前健康的口服避孕药（OC）使用者被随机分配转换为避孕环（CR）或贴片（CP），并在转换前以及新方法使用的第四个周期期间进行静脉穿刺以测量血栓形成的替代生物标志物[性激素结合球蛋白（SHBG）、游离蛋白S和活化蛋白C抵抗（APC-r）]。
在纳入的142名育龄妇女中，有120对样本可用于分析。CP使用者的SHBG较基线显著升高[平均变化（95%CI），+29.9 nM（9.6 - 50）]，而CR使用者则未升高[-1.6（-16.6至13.5）]。CP使用者的蛋白S较基线显著降低[平均变化-7.1%（-12.1至-2.1）]，而CR使用者则显著升高[+5.3%（1.1 - 9.6）]。两组的APC-r比值与基线相比均未发生显著变化[CP +0.06（-0.06至0.18），CR +0.02（-0.10至0.14）]。在第4周期访视时，与CR使用者相比，使用CP的受试者SHBG显著更高[187.5（167.0 - 208），146（132.6 - 159.4），p = 0.012]，蛋白S显著更低[81.8（76.8 - 86.8），93.6（89.1 - 98.1），p = 0.001]，且APC-r比值相似[2.99（2.85 - 3.14），3.09（2.96，3.22），p = 0.3]。
转换为阴道环的OC使用者在血栓形成生物标志物方面表现出有益变化，而转换为贴片的使用者则表现出有利于血栓形成的变化。
