低剂量口服避孕药和对活性蛋白C的获得耐药性:一个随机交叉研究
J Rosing1, S Middeldorp, J Curvers
1Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Netherlands. j.rosing@bioch.unimaas.nl
Lancet (London, England)
|January 15, 2000
概括
第三代口服避孕药,特别是那些含有德佐的避孕药,比第二代更明显地增加了对活性蛋白C (APC) 的耐药性. 这种获得的APC耐药性可能会导致用户血栓风险增加.
科学领域:
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
- 生殖健康 生殖健康
背景情况:
- 之前的研究表明,第三代口服避孕药 (OCs) 与第二代OCs相比,增加了对激活蛋白C (APC) 的抵抗力.
- 截面设计限制了早期的发现,因为潜在的偏差和不受控制的月经周期效应.
研究的目的:
- 调查第二代和第三代OC和APC耐药性之间的关联.
- 为了克服先前研究的偏见,使用循环控制的随机交叉试验.
主要方法:
- 一个随机交叉试验,涉及33名女性使用第二代 (莱沃诺格斯特勒) 或第三代 (德佐格斯特勒) 的OCs,每个周期为两次.
- 测量了血APC灵敏度比,评估了APC对血栓生成的影响.
- 对OC制剂进行了比较,并与聚合对照血进行了比较.
主要成果:
- 28名女性完成了这项研究.
- 这两种OC类型都增加了正常化的APC灵敏度比.
- 与第二代OCs与levonorgestrel (p<0.0001) 相比,使用desogestrel的第三代OCs显示了APC耐药性的显著增加.
结论:
- 口服避孕药的使用降低了APC在降低血栓形成的有效性,这种现象被称为获得APC耐药性.
- 这种获得的APC耐药性在含有desogestrel的OC中比含有levonorgestrel的OC更明显.
- 与静脉血栓栓塞风险相关的OC诱导的获得APC耐药性的临床意义需要进一步调查.
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