目的　探讨使用复方口服避孕药 (COC)与不同类型脑卒中发生的关系 ,以及遗传易感因素在服药妇女发生脑卒中的过程中作用。方法　选取 111例女性脑卒中患者 ,用基因多态性分析法观察凝血因子ⅤLeiden突变 (G16 91→A)、凝血酶原基因多态性 (G2 0 2 10→A)和血管紧张素转化酶(ACE)基因多态性 (I/D)的分布。运用病例 病例研究的方法分析危险因素在出血性和缺血性脑卒中之间的差异。结果　与未使用COC妇女相比 ,服药妇女发生出血性脑卒中的危险要显著高于缺血性脑卒中 (OR =3.0 3) ;体质指数≥ 2 4kg/m2 与缺血性脑卒中的联系强于出血性脑卒中 (OR =2 .99)。基因多态性分析未能找到G16 91→A和G2 0 2 10→A突变 ,D型ACE等位基因频率在缺血性脑卒中组中略高 ,但无显著性。结论　结果提示口服避孕药可能与出血性脑卒中有关 ,而未见与G16 91→A和G2 0 2 10→A突变以及ACE基因I/D多态性有相关性 Objective To explore the relationship between the use of compound oral contraceptives (COC) and different types of stroke and the role of genetic predisposition in taking a stroke in women. Methods One hundred and eleven women with stroke were enrolled in this study. The genetic polymorphisms of VLeiden mutation (G16 91 → A), prothrombin gene polymorphism (G2 0 2 10 → A) and angiotensin-converting enzyme ACE) gene polymorphism (I / D) distribution. The case study was used to analyze the differences in risk factors between hemorrhagic and ischemic stroke. Results Compared with women without COC, the risk of hemorrhagic stroke in women taking medication was significantly higher than that in ischemic stroke (OR = 3.03). The body mass index ≥24kg / m2 was associated with ischemic stroke In hemorrhagic stroke (OR = 2.99). Gene polymorphism analysis failed to find G16 91 → A and G2 0 2 10 → A mutations, D-type ACE allele frequency in ischemic stroke group was slightly higher, but no significant. Conclusion The results suggest that oral contraceptives may be related to hemorrhagic stroke, but not with G16 91 → A and G2 0 2 10 → A mutations and ACE gene I / D polymorphism