摘要
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。
The commonly used contraceptives currently are combined oral contraceptives（COC）which consist of estrogen and progestogen and are only available for women.Use of COC may cause several serious adverse reactions and one of them is venous thromboembolism（VTE）.VTE usually occurs within 1-2 years of starting COC use,but it is unaffected by duration of use,and disappeared after drug withdrawal.The risk of developing VTE among oral contraceptive users is 4 times that of nonusers.The occurrence of VTE is related to the dose of estrogen and the type of progestogen in combined oral contraceptives.The incidence of VTE is obviously reduced if the dose of estrogen is50 μg;and the risk of developing VTE is higher in third-generation oral contraceptives than in second-generation oral contraceptives.The mechanism of VTE might be that estrogen in COC promotes the activation of fibrinogen,increases level of the coagulation factors,decreases the level of antiprothrombin,and enhances the coagulation function.The risk factors for COC-induced VTE are cardiovascular diseases,advanced age,smoking,VTE or family history of VTE,and long-term bed rest.It is suggested that the women of reproductive age should be screened for the risk factors before receiving COC in order to decrease the risk of developing VTE.
出处
《药物不良反应杂志》
2010年第5期329-332,共4页
Adverse Drug Reactions Journal
关键词
口服避孕药
药物不良反应
静脉血栓栓塞
oral contraceptives
adverse drug reactions
venous thromboembosis
