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目的 研究长期服用国产低剂量复方炔诺酮 (1号片 )及低剂量复方 18 甲基炔诺酮 (复方 18 甲 )对健康妇女凝血系统的影响。方法 对连续服用低剂量 1号片和复方 18 甲 5～15年的观察组及同期使用宫内节育器 (IUD)对照组的健康妇女 1～ 1例 ,进行血浆中APTT、PT FIB(A)、PT FIB(B)、TT和凝血因子Ⅱ、ⅤⅦ、Ⅷ、Ⅹ活性测定。结果 两个服药组妇女血浆部分凝血指标有变化 ,其部分凝血活酶时间 (APTT)略低于对照组 (IUD) ,1号片组和对照组之间的差异达到显著性水平(P <0 0 5 ) ,两组因子X的活性水平均明显高于对照组 (P <0 0 5 ,P <0 0 1) ;1号片组因子Ⅷ的活性水平高于对照组 (P <0 0 5 )且因子Ⅶ的活性水平略有升高而复方 18 甲组因子Ⅶ的活性水平略有下降 (P >0 0 5 ) ,其它指标活性水平 3组间相似(P >0 0 5 )。结论 长期服用低剂量国产COCs对妇女的凝血系统有一负面影响 ,不同的避孕药对凝血的影响也略有不同 ,这可能与避孕药中雌孕激素的剂量、雌孕激素的配伍有关。但这些指标均值波动尚在正常范围内 ,未见有明显的临床意义
Objective To study the effects of long-term use of domestic low-dose compound norethindrone (No. 1 tablets) and low-dose norethindrone (18 A) on the coagulation system in healthy women. Methods A total of 1 to 1 healthy women undergoing continuous low-dose 1 and 18-A treatment for 5 to 15 years and IUD control group were enrolled in this study. Plasma APTT, PT FIB (A) , PT FIB (B), TT and coagulation factors Ⅱ, ⅤⅦ, Ⅷ, Ⅹ activity. Results The plasma coagulation indexes of two groups were changed, the partial thromboplastin time (APTT) was slightly lower than that of the control group (IUD), the difference between the No.1 group and the control group reached the significant level (P <0 The activity of factor X in both groups was significantly higher than that in control group (P <0.05, P <0.01). The activity of factor VIII in group 1 was higher than that in control group (P <0.05) ), While the activity of factor Ⅶ increased slightly while the activity of factor Ⅶ of compound 18 decreased slightly (P 0 05). The activity of other indicators was similar between the three groups (P 0 05). Conclusion Long-term use of low-dose domestic COCs has a negative impact on the coagulation system in women. The effects of different contraceptives on coagulation are also slightly different. This may be related to the dose of estrogen and progesterone in the contraceptives and the compatibility of estrogen and progesterone. However, the average value of these indicators is still within the normal range, no obvious clinical significance