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目前常用的避孕药为复方口服避孕药(COC),由雌激素和孕激素配伍而成,仅供女性应用。COC可致一些严重不良反应,其中之一为静脉血栓栓塞(venous thromboembolism,VTE)。VTE一般发生在COC开始使用1~2年内,但不受使用持续时间的影响,停药后VTE消失。服用COC者发生VTE的风险约为未服用者的4倍。VTE的发生与COC中雌激素含量和孕激素类型有关。COC制剂中雌激素含量<50μg时VTE发生率明显降低;第3代COC致VTE风险通常高于第2代COC。COC引致VTE的机制可能是与其所含雌激素促进纤维蛋白原活化、增高凝血因子水平、降低抗凝血酶原水平和增强凝血功能有关。COC致VTE的危险因素有心血管疾病、高龄、嗜烟、有VTE病史和(或)家族史及长期卧床。育龄期女性在服用COC前应进行危险因素筛查,以降低发生VTE的风险。
Commonly used contraceptives for the compound oral contraceptives (COC), made of estrogen and progesterone compatibility, only for women. COC can cause some serious adverse reactions, one of which is venous thromboembolism (VTE). VTE generally occurs within 1 to 2 years of COC start-up but is not affected by the duration of use. VTE disappears after discontinuation. The risk of developing VTE in patients taking COC is about 4 times that of unused people. The occurrence of VTE is related to the content of estrogen and the type of progestin in COC. The incidence of VTE in COC preparations was significantly lower than that of estrogen <50μg. The incidence of VTE in the third generation of COC was generally higher than that of the second generation of COC. The mechanism by which COC causes VTE may be related to the estrogen’s activation of fibrinogen, the increase of blood coagulation factor, the reduction of antithrombin and the enhancement of coagulation function. The risk factors for VTE caused by COC are cardiovascular disease, advanced age, addicted to smoking, history of VTE and / or family history and prolonged bed rest. Women of childbearing age should be screened for risk factors before taking COC to reduce the risk of developing VTE.