与含乙炔雌二醇的基于屈螺酮的口服避孕药相比，含埃斯雌醇的此类口服避孕药的止血效果降低。
Reduced hemostatic effects with drospirenone-based oral contraceptives containing estetrol vs. ethinyl estradiol.
作者信息
Kluft Cornelis, Zimmerman Yvette, Mawet Marie, Klipping Christine, Duijkers Ingrid J M, Neuteboom Jacoline, Foidart Jean-Michel, Bennink Herjan Coelingh
机构信息
Good Biomarker Sciences, Zernikedreef 8, 2333CL, Leiden, the Netherlands.
Pantarhei Bioscience, P.O. Box 464, 3700, AL, Zeist, the Netherlands.
出版信息
Contraception. 2017 Feb;95(2):140-147. doi: 10.1016/j.contraception.2016.08.018. Epub 2016 Sep 1.
OBJECTIVE
The effects of estetrol (E4), a natural fetal estrogen, combined with drospirenone (DRSP) were evaluated on plasma levels of sex hormone-binding globulin (SHBG), angiotensinogen and 12 hemostasis markers.
STUDY DESIGN
Combinations of 3 mg DRSP with 5 or 10 mg E4 were compared with YAZ® (20 mcg ethinyl estradiol and 3 mg DRSP; EE/DRSP) in parallel groups of 15-18 healthy young women. Main outcome was the relative change from pretreatment to the end (day 24±1) of the third treatment cycle.
RESULTS
All E4 combinations showed low estrogen impact compared to EE/DRSP. Effects on SHBG and angiotensinogen of 10 mg E4 combined with DRSP were 15%-20% that of EE/DRSP. Both E4/DRSP combinations reduced D-dimer level and the 5 mg E4/DRSP combination also decreased fragment 1+2.
CONCLUSIONS
The reduction in coagulation markers suggests an anticoagulant effect from DRSP. The indications of a low thrombosis risk for E4 preparations should be validated in larger studies. IMPLICATION STATEMENT.
目的
评估天然胎儿雌激素雌三醇（E4）与屈螺酮（DRSP）联合使用对性激素结合球蛋白（SHBG）、血管紧张素原和12种止血标志物血浆水平的影响。
研究设计
将3 mg DRSP与5或10 mg E4的组合与YAZ®（20 mcg炔雌醇和3 mg DRSP；EE/DRSP）在15 - 18名健康年轻女性的平行组中进行比较。主要结局是从预处理到第三个治疗周期结束（第24±1天）的相对变化。
结果
与EE/DRSP相比，所有E4组合显示出较低的雌激素影响。10 mg E4与DRSP联合使用对SHBG和血管紧张素原的影响是EE/DRSP的15% - 20%。两种E4/DRSP组合均降低了D - 二聚体水平，5 mg E4/DRSP组合还降低了1 + 2片段。
结论
凝血标志物的降低表明DRSP具有抗凝作用。E4制剂血栓形成风险低的迹象应在更大规模的研究中得到验证。意义声明。
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