Wright D, Poller L, Thomson J M, Burrows G E, Hirst C F, Sidebotham A
Department of Pathological Sciences, University of Manchester, UK.
Thromb Res. 1997 Mar 15;85(6):455-64. doi: 10.1016/s0049-3848(97)00035-2.
Although hormone replacement therapy (HRT) appears to protect women from ischaemic heart disease (IHD), its use is associated with increased factor clotting activity (VIIc), an independent risk factor for IHD. The nature of this factor VII rise was therefore examined in a cross-sectional study of 279 women aged between 40 and 65 years. Ninety-four were pre-menopausal, 44 were post-menopausal and taking HRT, whilst 141 were post-menopausal non-users. For those women on oestrogen-only HRT, the mean factor VIIc was 144%, compared to 130% for post-menopausal non-users, and 116% for those on combined HRT. These differences were significant (p = 0.01). Oestrogen-only users also had significantly higher mean levels of factor VIIa (3.3 ng/ml) compared to non-users (2.2 ng/ml) and those on oestrogen-progestogen HRT (2.2 ng/ml-p = 0.015). In contrast for factor VII antigen the mean values of the three groups were similar. Analysis of the age-regression slopes showed a significant age-related rise in factor VIIc of 1.2% per annum (p < 0.01) for post-menopausal non-users. There was a similar increase in factor VII antigen (2.1%) but no rise in factor VIIa. For all HRT users there was no change with age for any of the factor VII measures. Thus the age-related rise in factor VIIc appears to be due to an increase in factor VII zymogen alone, and taking HRT seems to abolish such a rise. In contrast, the increased factor VIIc seen with oestrogen-only HRT appears to be secondary to factor VII activation.
尽管激素替代疗法（HRT）似乎能保护女性免受缺血性心脏病（IHD）的影响，但其使用与凝血因子活性增加（VIIc）有关，而这是IHD的一个独立危险因素。因此，在一项对279名年龄在40至65岁之间的女性进行的横断面研究中，对这种因子VII升高的性质进行了研究。94名是绝经前女性，44名是绝经后且正在接受HRT的女性，而141名是绝经后未使用HRT的女性。对于仅接受雌激素HRT的女性，平均因子VIIc为144%，相比之下，绝经后未使用者为130%，接受联合HRT者为116%。这些差异具有统计学意义（p = 0.01）。仅使用雌激素的使用者的因子VIIa平均水平（3.3 ng/ml）也显著高于未使用者（2.2 ng/ml）和接受雌激素 - 孕激素HRT者（2.2 ng/ml - p = 0.015）。相比之下，三组的因子VII抗原平均值相似。对年龄回归斜率的分析表明，绝经后未使用者的因子VIIc每年有显著的与年龄相关的升高，为1.2%（p < 0.01）。因子VII抗原也有类似的升高（2.1%），但因子VIIa没有升高。对于所有HRT使用者，任何因子VII指标都不会随年龄变化。因此，因子VIIc与年龄相关的升高似乎仅归因于因子VII酶原的增加，而接受HRT似乎消除了这种升高。相比之下，仅使用雌激素的HRT中观察到的因子VIIc升高似乎是因子VII激活的结果。
