第三代口服避孕药和遗传性血栓形成倾向作为非致命性静脉血栓栓塞的危险因素。

Third generation oral contraceptives and heritable thrombophilia as risk factors of non-fatal venous thromboembolism.

作者信息

Andersen B S, Olsen J, Nielsen G L, Steffensen F H, Sørensen H T, Baech J, Gregersen H

机构信息

The Danish Epidemiology Science Centre at the Department of Epidemiology and Social Medicine, University of Aarhus, Denmark.

出版信息

Thromb Haemost. 1998 Jan;79(1):28-31.

PMID:9459317

Abstract

Third generation oral contraceptives (OCs) are apparently stronger risk factors for venous thromboembolism (VTE) than other OCs, however, the increased risk may be due to confounding by indication related to differences in prescription behaviour. We estimated the risk of VTE associated with use of OCs with and without the presence of Factor V Leiden mutation, protein C-, protein S- or antithrombin deficiency. Sixty-seven cases with VTE were compared with 134 controls. The risk of VTE in the presence of thrombophilia was of the same magnitude for third generation OC users as for users of other OCs; OR: 52.5 (95% CI: 3.7-738.1) and OR: 63.3 (95% CI: 6.2-648.4), respectively. It is unlikely that confounding by indication entirely explains the risk of VTE associated with third generation OCs since the combined effect exceeds what could be explained if this source of error was the only determinant of the association.

摘要

第三代口服避孕药（OCs）显然比其他口服避孕药更易引发静脉血栓栓塞（VTE），然而，风险增加可能是由于与处方行为差异相关的指征混杂因素所致。我们评估了在存在和不存在凝血因子V Leiden突变、蛋白C、蛋白S或抗凝血酶缺乏的情况下，使用口服避孕药与静脉血栓栓塞风险之间的关系。将67例静脉血栓栓塞病例与134例对照进行比较。对于第三代口服避孕药使用者和其他口服避孕药使用者，存在血栓形成倾向时静脉血栓栓塞的风险程度相同；比值比（OR）分别为52.5（95%置信区间：3.7 - 738.1）和63.3（95%置信区间：6.2 - 648.4）。由于联合效应超过了如果该误差来源是关联的唯一决定因素时所能解释的范围，因此不太可能是指征混杂完全解释了与第三代口服避孕药相关的静脉血栓栓塞风险。