David J L, Gaspard U J, Gillain D, Raskinet R, Lepot M R
Department of Medicine, State University of Liege, Centre Hospitalier Universitaire du Sart-Tilman, Belgium.
Am J Obstet Gynecol. 1990 Jul;163(1 Pt 2):420-3. doi: 10.1016/0002-9378(90)90594-w.
Thirty-six young, healthy, nonsmoking women have been selected to check the effect of low-dose oral contraceptives on hemostasis. Two identical groups were treated by Marvelon (a monophasic oral contraceptive containing ethinyl estradiol and desogestrel) or Trigynon (a triphasic oral contraceptive containing ethinyl estradiol and levonorgestrel) for a 6-month period. In the absence, previously controlled, of substantial differences between the effects of each treatment on hemostasis, all the results were pooled at the third and sixth month of the study. The effects of oral contraceptive treatment were as follows: (1) platelet number, platelet aggregating ratio, and plasma beta-thromboglobulin level were not significantly altered, and (2) antithrombin III activity was not reduced despite a slight decrease or antigen concentration. The von Willebrand factor parameters, factor VIII:C, factor VII:C, and clottable fibrinogen were significantly increased. Plasminogen (activity and antigen concentrates) and alpha 2-antiplasmin levels were also significantly increased. Activated partial thromboplastin time and euglobulin lysis time measured after venous occlusion were significantly shortened. Although statistical analysis did not show dramatic changes in all these parameters, some individual extreme values were substantially altered. Therefore we believe that these later values are worthy of cautious consideration for weighing the role that hemostasis factors might play in individual thrombotic risk.
36名年轻、健康、不吸烟的女性被挑选出来，以研究低剂量口服避孕药对止血的影响。将她们分为两组，分别服用妈富隆（一种含乙炔雌二醇和去氧孕烯的单相口服避孕药）或特居乐（一种含乙炔雌二醇和左炔诺孕酮的三相口服避孕药），为期6个月。由于每种治疗对止血的影响在之前的对照中没有显著差异，因此在研究的第三个月和第六个月将所有结果汇总。口服避孕药治疗的效果如下：（1）血小板数量、血小板聚集率和血浆β-血小板球蛋白水平没有显著改变；（2）尽管抗凝血酶III活性略有下降或抗原浓度降低，但抗凝血酶III活性并未降低。血管性血友病因子参数、因子VIII:C、因子VII:C和可凝纤维蛋白原显著增加。纤溶酶原（活性和抗原浓度）和α2-抗纤溶酶水平也显著增加。静脉阻塞后测得的活化部分凝血活酶时间和优球蛋白溶解时间显著缩短。虽然统计分析并未显示所有这些参数都有显著变化，但一些个体的极端值有很大改变。因此，我们认为在权衡止血因子在个体血栓形成风险中可能发挥的作用时，这些后期值值得谨慎考虑。
