Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Blood Rev. 2014 May;28(3):123-33. doi: 10.1016/j.blre.2014.03.005. Epub 2014 Apr 1.
The incidence of venous thromboembolism (VTE) is two-fold higher in women than in men during reproductive age, which is likely explained by the use of hormonal contraceptives and by pregnancy in this phase of life. After adjustment for these factors, men have a two-fold higher risk of developing a first VTE compared with women, which is in line with earlier observations that men have a two-fold higher risk of recurrent VTE. These findings indicate that the intrinsic risk of VTE is higher in men than in women. Hormonal contraceptives increase the risk of VTE and the risk varies per type, dose, and administration route. In women with a high baseline risk of VTE, avoidance of some hormonal contraceptives should be considered, as well as thrombosis prophylaxis during pregnancy. Presence of hereditary thrombophilia increases the risk of a first VTE episode. This review focuses on the differences in risk of VTE between men and women, hormonal risk factors for women, and how these interact with common types of hereditary thrombophilia.
静脉血栓栓塞症（VTE）的发生率在生育期女性中是男性的两倍，这可能与该阶段生活中使用激素避孕药和妊娠有关。在调整这些因素后，与女性相比，男性发生首次 VTE 的风险增加了一倍，这与之前的观察结果一致，即男性复发性 VTE 的风险增加了一倍。这些发现表明，VTE 的内在风险在男性中高于女性。激素避孕药会增加 VTE 的风险，并且每种类型、剂量和给药途径的风险都不同。对于 VTE 基线风险较高的女性，应考虑避免使用某些激素避孕药，并在妊娠期间进行血栓预防。遗传性血栓形成倾向的存在会增加首次 VTE 发作的风险。本综述重点介绍了男性和女性之间 VTE 风险的差异、女性的激素危险因素，以及这些因素如何与常见类型的遗传性血栓形成倾向相互作用。
