The Effect Of Combined Oral Contraceptive On Coagulation And Fibrinolytic Index

Objective:Treating patients who are suitable for taking combined oral contraceptives(COCs)with Diane 35(or YAZ)for 3 cycles,to observe its effect on coagulation and fibrinolytic index,to provide a theoretical basis for guiding clinical medication.Methods:Choosing 62 patients who taking COCs in the second hospital of Shanxi Medical University Department of Obstetrics and Gynecology outpatient from April 2017 to February 2018,.According to the patients' condition and voluntary patients,the patients were divided into Diane 35 groups(group A)31 cases and YAZ group(group B)31 cases with a method of non random concurrent control test.After entering the group,the related demographic data were recorded.Two groups of patients would take Diane 35(35 ug ethinyloestradiol and 2mg cyproterone acetate)or YAZ(20 ug ethinyloestradiol and 3mg drospirenone)in the first day of the menstrual cycle or withdrawal bleeding,1 pieces/days,and 3 cycles were taken in the two groups.Respectively,before,after oral administration of 1 and 3 cycles followed by the blood coagulation and fibrinolytic index changes.The indexes include prothrombin time(PT),activated partial thromboplastin time(APTT),prothrombin time activity(PTA),fibrinogen(FIB),international normalized ratio(INR),D-Dimer,thrombin antithrombin III complex(TAT)and tissue plasminogen activator plasminogen / activator inhibitor-1(tPAI·C).Results:(1)There was no difference in coagulation and fibrinolysis between the two groups of A and B.The trend of coagulation and fibrinolysis in two groups was consistent with time.(2)PT,APTT and INR of A group and B group in oral after 1 and 3 cycles respectively compared with oral significantly decreased(P < 0.05),FIB,PTA,TAT in oral after 1 and 3 cycles respectively compared with the oral increased significantly(P < 0.05),compared to the 1 and 3 indexes after oral administration,there was no statistical difference.(3)There was no statistical difference between the 2 time points and two groups of the change of D-Dimer.(4)The tPAI·C of the two groups of A and B decreased first and then increased with the prolongation of oral time,but the overall performance of the index was reduced.(5)In group A,1 cases of deep venous thrombosis of the left lower limbs were formed.Conclusion:(1)Oral administration of Diane 35 or YAZ can lead to changes in coagulation and fibrinolysis and is generally fluctuating in normal range.(2)After oral administration of Diane 35 or YAZ,coagulation index changes will appear first(PT?APTT?INR?FIB?PTA and TAT),which indicates that the activity of coagulation system.At the same time,the low expression of fibrinolytic index(tPAI·C)appeared.(3)Changes in coagulation and fibrinolysis were mainly concentrated in the first 1 months of oral contraceptives,and the indicators did not change over time.