Melhado-Kimura Vaneska, Bizzacchi Joyce Maria Annichino, Quaino Susan Kelly Picoli, Montalvao Silmara, Bahamondes Luis, Fernandes Arlete
Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil.
Blood Center, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
J Obstet Gynaecol Res. 2017 Jun;43(6):1054-1060. doi: 10.1111/jog.13306. Epub 2017 May 15.
The aim of this study was to assess the effects of the injectable depot-medroxyprogesterone acetate (DMPA) contraceptive on selected blood coagulation parameters in young, healthy new users.
The prospective study included 39 healthy women aged 20-39 years, with a body mass index (BMI; kg/m ) < 30, who were never users of DMPA, and who opted to use DMPA (21 women) or a copper intrauterine device (IUD; 18 women). The women in the two groups were matched for age (±1 year) and BMI (±1). Blood samples were obtained from all participants at baseline and at 6 and 12 months. Activated partial thromboplastin time, D-dimer, protein C, antithrombin, protein S, and thrombin generation test (lag time, endogenous thrombin potential, time to peak, and velocity index of thrombin generation) were analyzed. Repeated-measures analysis of variance was used to compare the groups.
There were no significant differences between the groups at baseline with respect to any of the parameters evaluated; however, in the DMPA group, D-dimer levels were lower and the time to peak thrombin generation was longer than in the IUD group at 12 months of evaluation.
Lower D-dimer and longer time to peak thrombin generation in new users of DMPA suggest a positive profile against hypercoagulability.
本研究旨在评估注射用醋酸甲羟孕酮长效避孕针（DMPA）对年轻、健康的新使用者某些凝血参数的影响。
这项前瞻性研究纳入了39名年龄在20 - 39岁、体重指数（BMI；kg/m²）< 30、从未使用过DMPA且选择使用DMPA（21名女性）或铜宫内节育器（IUD；18名女性）的健康女性。两组女性在年龄（±1岁）和BMI（±1）方面进行匹配。在基线、6个月和12个月时从所有参与者采集血样。分析活化部分凝血活酶时间、D - 二聚体、蛋白C、抗凝血酶、蛋白S以及凝血酶生成试验（延迟时间、内源性凝血酶潜力、达到峰值时间和凝血酶生成速度指数）。采用重复测量方差分析对两组进行比较。
在基线时，两组在任何评估参数方面均无显著差异；然而，在评估的12个月时，DMPA组的D - 二聚体水平较低，凝血酶生成达到峰值的时间比IUD组长。
DMPA新使用者中较低的D - 二聚体水平和较长的凝血酶生成达到峰值时间表明其在抗高凝状态方面具有积极表现。
