Patt V
Fortschr Med. 1976 Nov 18;94(33):1900-6.
Numerous interactions between hormonal contraceptives and liver function have been described. Changed laboratory results do not represent obligatory pathologic conditions or hepatotoxi effects. Some of these changed results are transient, suggesting that liver cells are capable of adaptation. The use of oral contraceptives is contraindicated in the following liver diseases: - recurrent intrahepatic cholestasis (recurrent jaundice of pregnancy, Dubin-Johnson syndrome, Rotor syndrome); - acute disturbances of liver function. In general it is recommended that hormonal contraceptives should not be used by patients with biliary cirrhosis although some authors have stated that chronic disturbances of liver function did not appear to be aggravated by these agents. Impairment of carbohydrate and lipid metabolism needs careful control of the laboratory tests concerned. Due to its low frequency the increased risk of gallstones does not necessitate the withdrawal of the medication. Up to now the interrelationship between the use of contraceptive steroids and the induction of hepatic tumours has not been proven.
激素避孕药与肝功能之间存在多种相互作用已被描述。实验室检查结果的改变并不一定代表病理性状况或肝毒性作用。其中一些改变的结果是短暂的,这表明肝细胞具有适应能力。以下肝脏疾病患者禁用口服避孕药:- 复发性肝内胆汁淤积症(妊娠复发性黄疸、杜宾-约翰逊综合征、罗托综合征);- 急性肝功能障碍。一般建议胆汁性肝硬化患者不应使用激素避孕药,尽管一些作者指出这些药物似乎不会加重慢性肝功能障碍。碳水化合物和脂质代谢受损需要密切监测相关的实验室检查。由于胆结石风险增加的发生率较低,无需停药。到目前为止,避孕类固醇的使用与肝肿瘤的诱发之间的相互关系尚未得到证实。