孕激素避孕在非过敏性血管性水肿中的益处。
Benefits of progestin contraception in non-allergic angioedema.
机构信息
Gynaecological Endocrinology Unit, Paris Descartes University, Port Royal Cochin, APHP, Paris, France.
出版信息
Clin Exp Allergy. 2013 Apr;43(4):475-82. doi: 10.1111/cea.12055.
BACKGROUND
Hereditary angioedema attacks can be induced or worsened by oral contraceptive containing oestrogens.
OBJECTIVES
The purpose of this study was to assess the impact of progestin contraceptives on angioedema attacks.
METHODS
We conducted a French retrospective, multi-centre study of progestin contraception in women with non-allergic angioedema, including hereditary angioedema type I, II and III and idiopathic angioedema. Patients were classified into four groups according to frequency of attacks. We evaluated the effects of progestin on the mean number of attacks and compared the number of patients in each group before and under progestin contraception. The influence of hormonal factors on the course of angioedema was also assessed.
RESULTS
Fifty-five women were included: mean age was 32.1 years (16-52) and mean follow-up 32.4 months (SD:29). Fourteen women were classified as type I (25.4%), two as type II (3.6%) and 19 as type III (34%) and 20 were idiopathic (36%). Seventeen patients were taking a low dose progestin-only pill (POP), 24 antigonadotropic progestins (AGP) and 14 both successively. Total or partial improvement was observed in 81.8% (45/55) of the patients and more frequently in those on an AGP agent (34 patients, 89.5%) than on POP (19 patients, 61.3%) (P = 0.013).
CONCLUSIONS & CLINICAL RELEVANCE: This is the first study evaluating the interest of antigonadotropic progestin contraception in a series of women with non-allergic angioedema. Progestins, especially antigonadotropic progestins, appear to convey a marked benefit in most cases. Antigonadotropic progestins could thus be recommended as adjuvant treatment in childbearing women with non-allergic angioedema.
背景
含雌激素的口服避孕药可诱发或加重遗传性血管性水肿发作。
目的
本研究旨在评估孕激素避孕药对血管性水肿发作的影响。
方法
我们进行了一项法国回顾性、多中心研究，纳入了非过敏性血管性水肿（包括 I 型、II 型和 III 型遗传性血管性水肿和特发性血管性水肿）妇女的孕激素避孕情况。根据发作频率将患者分为四组。我们评估了孕激素对平均发作次数的影响，并比较了孕激素避孕前后每组患者的数量。还评估了激素因素对血管性水肿病程的影响。
结果
共纳入 55 例女性患者：平均年龄为 32.1 岁（16-52 岁），平均随访时间为 32.4 个月（SD：29）。14 例患者被归类为 I 型（25.4%），2 例为 II 型（3.6%），19 例为 III 型（34%），20 例为特发性（36%）。17 例患者服用低剂量孕激素避孕药（POP），24 例服用抗促性腺激素孕激素（AGP），14 例先后服用。81.8%（45/55）的患者病情得到完全或部分改善，其中使用 AGP 制剂（34 例，89.5%）的患者比使用 POP（19 例，61.3%）的患者更常见（P=0.013）。
结论与临床相关性
这是第一项评估非过敏性血管性水肿患者系列使用抗促性腺激素孕激素避孕的效果的研究。孕激素，尤其是抗促性腺激素孕激素，在大多数情况下似乎具有显著益处。因此，抗促性腺激素孕激素可作为非过敏性血管性水肿有生育需求妇女的辅助治疗。
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