Kapiotis S, Jilma B, Pernerstorfer T, Stohlawetz P, Eichler H G, Speiser W
Department of Clinical Pharmacology-TARGET, General Hospital Vienna, University of Vienna, Austria.
Thromb Haemost. 1998 Oct;80(4):588-91.
Men have an increased cardiovascular risk as compared to women, which is largely ascribed to the cardioprotective effects of female sex steroids. We hypothesised that this may be reflected by differences in the activation status of the coagulation system. Hence the aim of this study was to compare plasma levels of activated factor VII (FVIIa) in men and women, and to study the influence of the menstrual cycle on FVIIa levels. In a prospective study we investigated 20 healthy young women and 20 men. Men had significantly higher levels of activated factor VII (60 mU/ml, CI: 52 to 67) than women during all phases of the menstrual cycle. In women FVIIa was higher during the follicular phase (41 mU/ml, CI: 33 to 50) than during midcycle (34 mU/ml, CI: 24 to 45; p = 0.022 vs. follicular phase) and during the luteal phase (33 mU/ml, CI: 24 to 42; p = 0.006 vs. follicular phase). Prothrombin fragment (F1 + 2) levels decreased from 0.86 nmol/l (CI: 0.51-1.21) by -23% (-39% to -8%; p = 0.011) during midcycle and by -25% (CI: -51% to 1%; p = 0.023) during the luteal phase. These data support the contention that plasma levels of FVIIa, a key enzyme of the coagulation cascade, may be down-regulated by endogenously produced female sex hormones during the menstrual cycle. This may at least partially explain the marked gender differences found in FVIIa.
与女性相比，男性患心血管疾病的风险更高，这在很大程度上归因于女性性激素的心脏保护作用。我们假设这可能反映在凝血系统激活状态的差异上。因此，本研究的目的是比较男性和女性血浆中活化因子VII（FVIIa）的水平，并研究月经周期对FVIIa水平的影响。在一项前瞻性研究中，我们调查了20名健康年轻女性和20名男性。在月经周期的所有阶段，男性的活化因子VII水平（60 mU/ml，CI：52至67）显著高于女性。在女性中，FVIIa在卵泡期（41 mU/ml，CI：33至50）高于月经周期中期（34 mU/ml，CI：24至45；与卵泡期相比，p = 0.022）和黄体期（33 mU/ml，CI：24至42；与卵泡期相比，p = 0.006）。凝血酶原片段（F1 + 2）水平在月经周期中期下降了-23%（-39%至-8%；p = 0.011），从0.86 nmol/l（CI：0.51 - 1.21）降至0.66 nmol/l，在黄体期下降了-25%（CI：-51%至1%；p = 0.023）。这些数据支持了这样的观点，即凝血级联反应的关键酶FVIIa的血浆水平在月经周期中可能受到内源性产生的女性性激素的下调。这可能至少部分解释了FVIIa中发现的明显性别差异。
