Mohamed Abdulrahman B O, Al-Ama Nabeel, Al Kreathy Huda, Ahmed Khalid H B, Al Amri Turki, Harakeh Steve, Mousa Shaker A, De Laat Bas
Department of Pharmacology, Faculty of Medicine, 37848King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA).
Synapse Research Institute, Maastricht, the Netherlands.
Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620966051. doi: 10.1177/1076029620966051.
Saudi women have recently started using oral contraceptives (OCs), which has led to risk of venous thromboembolism (VTE). The risk varies with the type of OC generations used, and with OC use the risk for VTE increases by 2- to 6-fold. This study evaluated the effect of OC types in relation to ABO blood group on the risk of VTE among Saudi women. Thrombin generation (TG) was measured in the plasma of the women in the presence and absence of platelet rich plasma, platelet poor plasma and thrombomodulin or activated protein C. OC usage increased TG parameters ETP and Peak height by 9.81% and 16.04%, respectively. An increased risk of VTE was seen among women on third generation OCs as compared to those on second generation products. Within OC generations, we found that for women using fourth generation OCs, their ETP increased by 36.18% as compared to those using second generation and by 6.07% in those using third generation compared to those using second generation. There was significant difference with respect to ABO blood groups and OC generation types, but larger sample size is required. Women who are 40 years and older and using third generation OC had a higher risk of having thrombosis (11.84%), as compared to those using second generation OC (8.79%) and to those using fourth generation OC (5.03%). An association between different OC groups and non-O blood group in thrombosis generation was noted. TG parameters were significantly increased in relation to BMI when comparing to OC users versus non-users. In addition, inhibition of TG parameters in the presence of recombinant human thrombomodulin (TM) and activated protein C (APC) were significantly increased.
沙特女性最近开始使用口服避孕药（OCs），这导致了静脉血栓栓塞（VTE）的风险。风险因所使用的OCs代型而异，使用OCs会使VTE风险增加2至6倍。本研究评估了OC类型与ABO血型对沙特女性VTE风险的影响。在有和没有富血小板血浆、贫血小板血浆以及血栓调节蛋白或活化蛋白C的情况下，测量了这些女性血浆中的凝血酶生成（TG）。使用OCs分别使TG参数ETP和峰值高度增加了9.81%和16.04%。与使用第二代产品的女性相比，使用第三代OCs的女性发生VTE的风险增加。在OC各代型中，我们发现，使用第四代OCs的女性，其ETP与使用第二代OCs的女性相比增加了36.18%，与使用第三代OCs的女性相比增加了6.07%。ABO血型和OC代型之间存在显著差异，但需要更大的样本量。40岁及以上且使用第三代OC的女性发生血栓形成的风险更高（11.84%），相比之下，使用第二代OC的女性为（8.79%），使用第四代OC的女性为（5.03%）。注意到不同OC组与血栓形成中的非O血型之间存在关联。与未使用OC的女性相比，OC使用者的TG参数与BMI显著相关。此外，在重组人血栓调节蛋白（TM）和活化蛋白C（APC）存在的情况下，TG参数的抑制作用显著增强。
