Cohen H, Mackie I J, Walshe K, Gillmer M D, Machin S J
Department of Haematology, Middlesex Hospital, London.
Br J Haematol. 1988 Jun;69(2):259-63. doi: 10.1111/j.1365-2141.1988.tb07631.x.
The effects of two cyclically administered, triphasic, combined low dosage oestrogen and progestogen oral contraceptives on haemostasis have been compared in a longitudinal study, over 6 months, in 26 healthy females aged 16-30 years. Subjects received either Logynon (ethinyl oestradiol and Levonorgestrol, n = 14) or SHD 415G (Schering U.K., n = 12), which contains a similar dosage of ethinyl oestradiol, but in combination with a new progestogen, gestodene. Both groups showed increases in biological activities of procoagulant factors fibrinogen, X and XII and decreased activity of the naturally occurring coagulation inhibitor antithrombin III (AT-III). The majority of these changes were statistically significant (P less than 0.05 to less than 0.001), apparent after one cycle and maintained over the six cycle period. FVII activity increased in both groups, achieving statistical significance (P less than 0.01) by cycle 6 in the SHD 415G group but not in the females receiving Logynon. Protein C activity remained unchanged in both groups. Between-group comparisons showed no differences in the procoagulant factor changes, but protein C was lower (P less than 0.05) in the SHD 415G group after three cycles of therapy. These findings indicate that both triphasic oral contraceptives Logynon and SHD 415G induce increases in procoagulant factor activities which are not balanced by increased biological levels of the two most important physiological coagulation inhibitors AT-III and protein C. These prothrombotic changes are not modified by the new progestogen, gestodene.
在一项针对26名年龄在16至30岁的健康女性进行的为期6个月的纵向研究中，比较了两种周期性服用的三相低剂量雌激素和孕激素复方口服避孕药对止血的影响。受试者分别服用洛吉农（炔雌醇和左炔诺孕酮，n = 14）或SHD 415G（英国先灵公司，n = 12），后者含有相似剂量的炔雌醇，但与一种新型孕激素孕二烯酮联合使用。两组的促凝血因子纤维蛋白原、X因子和XII因子的生物活性均升高，而天然存在的凝血抑制剂抗凝血酶III（AT - III）的活性降低。这些变化大多具有统计学意义（P小于0.05至小于0.001），在一个周期后明显出现，并在六个周期内持续存在。两组的FVII活性均升高，SHD 415G组在第6周期达到统计学意义（P小于0.01），而服用洛吉农的女性则未达到。两组的蛋白C活性均保持不变。组间比较显示促凝血因子变化无差异，但在三个治疗周期后，SHD 415G组的蛋白C较低（P小于0.05）。这些发现表明，三相口服避孕药洛吉农和SHD 415G均会导致促凝血因子活性增加，而两种最重要的生理性凝血抑制剂AT - III和蛋白C的生物水平升高并未平衡这种增加。这些促血栓形成的变化并未因新型孕激素孕二烯酮而改变。
