Department of Vascular Diseases, University Medical Centre, Ljubljana, Slovenia.
Thromb Res. 2013 Nov;132(5):621-6. doi: 10.1016/j.thromres.2013.09.006. Epub 2013 Sep 13.
In women who suffer venous thrombosis (VT) during oral contraceptive (OC) use, a transient risk factor (OC) is removed during the acute event, while most co-existing forms of thrombophilia persist and presumably continue to maintain hypercoagulability. The aim of this study was to establish if hypercoagulability persists long after OC-related VT and if it could be attributed to thrombophilia.
60 women (age 33.0 ± 8.5 years) were investigated 5 - 64 (median 33) months after OC-related VT (patients) and compared to 63 apparently healthy women (controls). All women were tested for thrombophilia, activated partial thromboplastin time (APTT), fibrinogen, D-dimer, P-selectin and C-reactive protein. Thrombin generation was measured by Technothrombin® TGA assay. Overall haemostasis potential (OHP) assay with overall coagulation potential (OCP) and overall fibrinolytic potential (OFP) as supplementary parameters were measured by repeated fibrin formation and degradation registration.
In patients increased endogenous thrombin potential (4,205 ± 440 nM x min vs 4,015 ± 421 nM x min, p=0.017), increased OCP (22.6 ± 4.6 Abs-sum vs 20.8 ± 4.1 Abs-sum, p=0.025), shorter APTT (30.9 ± 3.8s vs 33.4 ± 3.6s, p<0.001) and lower antithrombin activity (99, 93-105% vs 104, 100-109%, p<0.05) were observed. Thrombophilia was observed in 22/60 (36%) patients and in 5/63 (7.9%, p<0.001) controls. The only significant difference between thrombophilic and non-thrombophilic patients was higher soluble P-selectin in the former subgroup (22, 20-33 μg/L vs 17, 12-22 μg/L, p=0.012).
In women with a history of OC-related VT persistent hypercoagulability was observed, which, however was not augmented by the presence of thrombophilia.
在口服避孕药（OC）使用期间发生静脉血栓形成（VT）的女性中，急性事件期间去除了短暂的危险因素（OC），而大多数共存的血栓形成倾向仍然存在，并可能继续维持高凝状态。本研究的目的是确定 OC 相关 VT 后是否长期存在高凝状态，以及是否可以归因于血栓形成倾向。
60 名女性（年龄 33.0±8.5 岁）在 OC 相关 VT 后 5-64 个月（中位数 33 个月）进行了研究（患者），并与 63 名健康女性（对照组）进行了比较。所有女性均进行了血栓形成倾向、活化部分凝血活酶时间（APTT）、纤维蛋白原、D-二聚体、P-选择素和 C 反应蛋白检测。通过 Technothrombin®TGA 测定法测量凝血酶生成。通过重复纤维蛋白形成和降解登记，用总体止血潜能（OHP）测定法测量总体凝血潜能（OCP）和总体纤维蛋白溶解潜能（OFP）作为补充参数。
患者的内源性凝血酶潜能增加（4,205±440 nM x min 比 4,015±421 nM x min，p=0.017），OCP 增加（22.6±4.6 Abs-sum 比 20.8±4.1 Abs-sum，p=0.025），APTT 缩短（30.9±3.8s 比 33.4±3.6s，p<0.001）和抗凝血酶活性降低（99，93-105% 比 104，100-109%，p<0.05）。60 名患者中有 22 名（36%）存在血栓形成倾向，63 名对照中有 5 名（7.9%，p<0.001）。血栓形成倾向患者与非血栓形成倾向患者唯一的显著差异是前者亚组中可溶性 P-选择素较高（22，20-33μg/L 比 17，12-22μg/L，p=0.012）。
在有 OC 相关 VT 病史的女性中，观察到持续的高凝状态，但血栓形成倾向并未加重这种状态。
