组合荷尔蒙避孕药使用者的缺血性中风:丹麦注册研究
Gasper Letnar1, Klaus Kaae Andersen1, Tom Skyhøj Olsen2
1Omicron ApS, Copenhagen, Telefonvej 8d 2860 Søborg, Denmark (G.L., K.K.A.).
Stroke
|December 9, 2024
概括
组合激素避孕药 (CHCs) 与缺血性中风的风险较高有关,但风险因乙烯 Estradiol 剂量而异. 与第二代CHC相比,第四代孕激素的中风风险较低.
科学领域:
- 生殖健康 生殖健康
- 心血管健康 心血管健康
- 药物监督 药物监督 药物监督
背景情况:
- 组合激素避孕药 (CHCs) 在全球范围内被广泛使用.
- 关于与低剂量乙烯基 Estradiol CHCs 和较新的第四代孕激素相关的缺血性中风风险仍然存在不确定性.
研究的目的:
- 调查与非使用者相比,CHC使用者中缺血性中风的发病率比率 (IRR).
- 分析基于乙烯乙醇含量,孕激素生成和CHCs的施用途径的中风风险.
主要方法:
- 在丹麦 (2004-2021) 进行的一项全国性队列研究包括1,711,757名年龄在18-49岁的非怀孕妇女.
- 使用了普森回归模型,调整了人口和临床因素.
- 分析对基于乙inylestradiol剂量,孕激素生成 (第二,第三,第四次) 和给药类型的CHC进行了比较.
主要成果:
- 与不使用CHC相比,CHC使用与缺血性中风的IRR增加1.77倍.
- 在服用30-40μg和≤20μg乙烯 Estradiol的CHC之间没有观察到中风风险的显著差异.
- 第四代CHC使用者的中风风险比第二代CHC使用者低30% (IRR为0.70).
结论:
- 组合使用荷尔蒙避孕药会增加缺血性中风的风险,不论其乙烯 Estradiol 含量 (<50μg).
- 与第二代选择相比,第四代孕激素含有CHCs在缺血性中风风险方面表现出潜在的更安全的个人资料.
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