Meade T W, Brozović M, Chakrabarth R, Howarth D J, North W R, Stirling Y
Br J Haematol. 1976 Nov;34(3):353-64. doi: 10.1111/j.1365-2141.1976.tb03582.x.
Factors V, VII and VIII (each determined by biological assay), fibrinogen, platelet count and adhesiveness, and fibrinolytic activity were measured in 234 white pre-menopausal women, of whom 57 (24%) were on oral contraceptives and 177 (76%) were not. Cholesterol, triglyceride and blood pressure levels were also recorded. In 20 of the women on oral contraceptives, and in an age-matched group of 20 who were not, prothrombin, factor X, antithrombin III and alpha 2-macroglobulin levels were determined, and factors VII and VIII were also measured immunologically. For the majority of the variables studied, the differences between those using and not using oral contraceptives were greater in younger than older women; in the case of factor VII (biological assay) and fibrinogen, the differences between the regression slopes on age were statistically significant, and mean values were substantially higher in those on oral contraceptives. There was also a significant difference between regression slopes on age for cholesterol. Mean levels of prothrombin, factors VII (immunological assay) and X, triglycerides and blood pressure were significantly higher, and mean levels of antithrombin III significantly lower, in those on oral contraceptives compared with those not. Overall, fibrinolytic activity was significantly higher in the women on oral contraceptives; this difference was, however, almost entirely due to the greatly increased fibrinolytic activity of the non-smokers on oral contraceptives, activity in the smokers on oral contraceptives being similar to that of the women not on these preparations. There were no significant differences in mean platelet count or adhesiveness, or in haemoglobin, packed cell volume, uric acid and blood sugar levels. Among the women on oral contraceptives, there was a significant negative correlation between factor VIII and fibrinolytic activity; this was largely due to five women all of blood groups A and B, in whom, besides high factor-VIII levels and poor fibrinolytic activity, other variables (e.g. fibrinogen) were raised in a direction that might be expected to favour thrombogenesis. It is possible that it is those women whose fibrinolytic activity does not increase in order to compensate for the effects of oral contraceptives on clotting factors, lipids and blood pressure, who are at special risk of thromboembolic episodes. The differential effects of oral contraceptives by age must be borne in mind in evaluating the effects of these preparations on the haemostatic and lipid systems.
对234名绝经前白人女性进行了凝血因子V、VII和VIII（均通过生物学检测法测定）、纤维蛋白原、血小板计数及黏附性以及纤溶活性的检测，其中57名（24%）服用口服避孕药，177名（76%）未服用。还记录了胆固醇、甘油三酯和血压水平。对20名服用口服避孕药的女性以及与之年龄匹配的20名未服用口服避孕药的女性，测定了凝血酶原、因子X、抗凝血酶III和α2-巨球蛋白水平，并通过免疫学法检测了因子VII和VIII。对于所研究的大多数变量，服用和未服用口服避孕药的女性之间的差异在年轻女性中比在年长女性中更大；就因子VII（生物学检测法）和纤维蛋白原而言，年龄回归斜率之间的差异具有统计学意义，服用口服避孕药者的均值显著更高。胆固醇的年龄回归斜率之间也存在显著差异。与未服用者相比,服用口服避孕药者的凝血酶原、因子VII（免疫检测法）和X、甘油三酯及血压的均值显著更高，而抗凝血酶III的均值显著更低。总体而言，服用口服避孕药女性的纤溶活性显著更高；然而，这种差异几乎完全归因于未吸烟的服用口服避孕药女性纤溶活性大幅增加，服用口服避孕药的吸烟女性的活性与未服用这些制剂的女性相似。平均血小板计数及黏附性、血红蛋白、血细胞比容、尿酸和血糖水平无显著差异。在服用口服避孕药的女性中，因子VIII与纤溶活性之间存在显著负相关；这主要归因于5名血型均为A和B的女性，她们除了因子VIII水平高和纤溶活性差之外，其他变量（如纤维蛋白原）也朝着可能有利于血栓形成的方向升高。有可能正是那些纤溶活性未增加以补偿口服避孕药对凝血因子、脂质和血压影响的女性有发生血栓栓塞事件的特殊风险。在评估这些制剂对止血和脂质系统的影响时，必须考虑口服避孕药随年龄产生的不同效应。
