Abbate R, Pinto S, Rostagno C, Bruni V, Rosati D, Mariani G
Clinica Medica I, Università di Firenze, Italy.
Am J Obstet Gynecol. 1990 Jul;163(1 Pt 2):424-9. doi: 10.1016/0002-9378(90)90595-x.
The purpose of this study was to evaluate the behavior of the hemostatic system during treatment with gestodene-containing oral contraceptives in monophasic (SHD 356, n = 15) and triphasic (SHD 415, n = 15) formulations. No changes in platelet (beta-thromboglobulin, platelet aggregate ratio, and megathrombocyte) and routine clotting assays were observed. Factor VIIc/factor VIIag ratio and fibrinopeptide A values showed a significant (p less than 0.005) increase after three cycles of both treatments. A slight, significant increase (p less than 0.01) in antithrombin III activity was observed during triphasic treatment. Protein C was unchanged. Fibrinolytic activity and plasminogen levels were significantly increased (p less than 0.05 and p less than 0.001). After 6 and 9 months, the factor VIIc/factor VIIag ratio was still significantly enhanced, whereas fibrinopeptide A values significantly (p less than 0.05) decreased, even if they were higher (p less than 0.05) than basal values. The persistence of factor VII activation without enhanced thrombin formation after long-term use of oral contraceptives suggests that at that time the activity of antithrombotic mechanisms counteracts the prothrombotic tendency, thus helping to minimize unwanted side effects on hemostasis during long-term drug administration.
本研究的目的是评估单相（SHD 356，n = 15）和三相（SHD 415，n = 15）含孕二烯酮口服避孕药治疗期间止血系统的行为。未观察到血小板（β-血小板球蛋白、血小板聚集率和巨型血小板）及常规凝血检测的变化。两种治疗三个周期后，因子VIIc/因子VIIag比值和纤维蛋白肽A值均显著升高（p < 0.005）。三相治疗期间，抗凝血酶III活性有轻微显著升高（p < 0.01）。蛋白C无变化。纤维蛋白溶解活性和纤溶酶原水平显著升高（p < 0.05和p < 0.001）。6个月和9个月后，因子VIIc/因子VIIag比值仍显著升高，而纤维蛋白肽A值显著降低（p < 0.05），即便仍高于基础值（p < 0.05）。长期使用口服避孕药后，因子VII持续激活但凝血酶生成未增强，这表明此时抗血栓形成机制的活性可抵消促血栓形成倾向，从而有助于在长期给药期间将对止血的不良副作用降至最低。
