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日本口服避孕药相关血栓栓塞的流行病学特征:一项全国性调查结果

The epidemiological characteristics of thromboembolism related to oral contraceptives in Japan: Results of a national survey.

作者信息

Sugiura Kazuko, Kobayashi Takao, Ojima Toshiyuki

机构信息

Department of Reproductive Health Nursing/Midwifery, Nagoya City University Graduate School of Nursing, Nagoya, Japan.

Department of Obstetrics and Gynecology, Hamamatsu Medical Center, Hamamatsu, Japan.

出版信息

J Obstet Gynaecol Res. 2021 Jan;47(1):198-207. doi: 10.1111/jog.14452. Epub 2020 Sep 3.

Abstract

AIM

The aim of this study was to reveal the epidemiological characteristics of thromboembolism related to combined oral contraceptives (COCs) in Japan.

METHODS

A survey of confirmed thromboembolism patients among Japanese COC users was conducted at randomly selected hospitals from across Japan. The survey examined six types of venous thromboembolism (VTE) and arterial thromboembolism (ATE) in all COC users: pulmonary embolism, deep vein thrombosis, other venous thrombosis, cerebral infarction, myocardial infarction, and other arterial thrombosis. The survey covered 5 years from 2009 to 2013. This study was approved in an ethical review by Hamamatsu University School of Medicine.

RESULTS

Four hundred and twenty-five cases clearly related to COCs were analyzed. The annual estimated incidence rates per 10 000 person-years of VTE, ATE and all thromboembolisms in all COC users were 1.17, 0.33 and 1.50, respectively. The incidence of thromboembolism was 35.2% within 30 days from the start of COCs, 53.8% within 90 days, 66.9% within 180 days and 78.2% within 360 days regardless of progestin type. Age adjusted odds ratios in the obese and underweight groups were 2.33 and 0.98 for overall thromboembolism, 2.59 and 0.77 for VTE, and 1.11 and 1.28 for ATE compared with the standard group, respectively. Odds ratios for thromboembolism in non-O blood groups were 1.89 for overall thromboembolism, 2.16 for VTE, and 1.35 for ATE, when compared with the O blood group.

CONCLUSION

The epidemiological characteristics of COC-related thromboembolisms were revealed in this national survey covering the years from 2009 to 2013.

摘要

目的

本研究旨在揭示日本与复方口服避孕药(COC)相关的血栓栓塞的流行病学特征。

方法

在日本各地随机选择的医院对确诊的使用COC的日本血栓栓塞患者进行调查。该调查在所有使用COC的人群中检查了六种类型的静脉血栓栓塞(VTE)和动脉血栓栓塞(ATE):肺栓塞、深静脉血栓形成、其他静脉血栓形成、脑梗死、心肌梗死和其他动脉血栓形成。该调查涵盖了2009年至2013年的5年时间。本研究经滨松医科大学医学院伦理审查批准。

结果

对425例与COC明确相关的病例进行了分析。所有使用COC的人群中,每10000人年VTE、ATE和所有血栓栓塞的年估计发病率分别为1.17、0.33和1.50。无论孕激素类型如何,血栓栓塞的发生率在开始使用COC后30天内为35.2%,90天内为53.8%,180天内为66.9%,360天内为78.2%。与标准组相比,肥胖和体重过轻组的年龄调整后总体血栓栓塞的优势比分别为2.33和0.98,VTE的优势比分别为2.59和0.77,ATE的优势比分别为1.11和1.28。与O血型组相比,非O血型组血栓栓塞的总体优势比为1.89,VTE为2.16,ATE为1.35。

结论

在这项涵盖2009年至2013年的全国性调查中揭示了与COC相关的血栓栓塞的流行病学特征。

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