Beigbeder J Y, Klouche K, Gallay P, Levy G, Grolleau R
Service de cardiologie, hôpital Saint-Eloi.
Arch Mal Coeur Vaiss. 1990 Jun;83(7):1015-8.
An 18-year-old woman presented with a large anterior myocardial infarction. Her cardiovascular risk factors were cigarette smoking in moderation and oral contraception with a synthetic oestroprogestative pill prescribed a few months previously. Coronary angiography showed occlusion of the left anterior descending artery but no other lesions. Biological investigations excluded an abnormality of coagulation. Antibodies to synthetic steroids (ethinylestradiol and progesterone) and circulating immune complexes were found in the serum. The role of antiethinylestradiol antibodies in the mechanism of myocardial infarction is discussed. These antibodies are present in 30 per cent of women taking oral contraceptives and their titres are significantly higher in 90 per cent of women who develop vascular thrombosis unrelated to atherosclerosis. The mechanism of the thrombogenic action of the antibodies and circulating immune complexes is also considered.
一名18岁女性出现大面积前壁心肌梗死。她的心血管危险因素为适度吸烟以及几个月前开始服用的含合成雌激素-孕激素的口服避孕药。冠状动脉造影显示左前降支闭塞，但无其他病变。生物学检查排除了凝血异常。血清中发现了抗合成类固醇（炔雌醇和孕酮）抗体及循环免疫复合物。讨论了抗炔雌醇抗体在心肌梗死机制中的作用。这些抗体存在于30%服用口服避孕药的女性中，在90%发生与动脉粥样硬化无关的血管血栓形成的女性中其滴度显著更高。还探讨了抗体及循环免疫复合物的促血栓形成作用机制。
