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Diabetes Care:糖尿病妇女避孕措施有讲究!

2016-12-02 haofan MedSci原创

在1型或2型糖尿病患者采用激素避孕发生血栓栓塞的绝对风险较低。而对于希望通过仔细规划妊娠来避免高血糖致畸作用的糖尿病女性来说,宫内和皮下避孕是一种高效而且不错的选择。

近日,糖尿病领域权威杂志Diabetes Care发表了一篇研究文章,旨在评估1型或2型糖尿病妇女采用激素避孕在血栓栓塞事件方面的安全性。

研究人员用来分析的数据来自于2002–2011年期间Clinformatics数据库内年龄在14-44岁的美国妇女,并且这些参与者根据ICD-9-CM糖尿病代码、进行糖尿病处方药治疗或使用糖尿病治疗设备来确定患有糖尿病。


研究人员检查了激素避孕妇女的避孕情况,并采用调整后的Cox回归模型比较了采用激素避孕的糖尿病妇女中出现血栓栓塞(静脉血栓、卒中或心肌梗死)的时间,研究人员在该模型中控制了参与者的年龄、吸烟、肥胖、高血压、高血脂、糖尿病并发症和癌症病史;并且研究者除去了参与者分娩后3个月的数据。

研究者纳入的146,080例糖尿病患者中,共有3012次血栓栓塞事件。只有28%的育龄糖尿病妇女声称进行过激素避孕,并且这些妇女大多数服用的是含雌激素的口服避孕药。研究者发现在使用避孕贴片的女性中血栓栓塞发生率最高(每1000例妇女每年有16例),而在采用宫内避孕(每1000例妇女每年有6例)和皮下避孕(每163例妇女每年0例)的妇女中血栓栓塞发生率最低。与采用宫内避孕相比,单纯注射孕激素避孕与血栓栓塞的风险增加有关(每1000例妇女每年有12.5例;调整后的风险比为4.69[95%可信区间为2.51-8.77])。

综上所述,在1型或2型糖尿病患者采用激素避孕发生血栓栓塞的绝对风险较低,而对于希望通过仔细规划妊娠来避免高血糖致畸作用的糖尿病女性来说,宫内和皮下避孕是一种高效而且不错的选择。

原始出处:

Sarah H. O’Brien,et al. Hormonal Contraception and Risk of Thromboembolism in Women With Diabetes. Diabetes Care, 2016.Nov.

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    2016-12-05 ylzr123

    在1型或2型糖尿病患者采用激素避孕发生血栓栓塞的绝对风险较低,而对于希望通过仔细规划妊娠来避免高血糖致畸作用的糖尿病女性来说,宫内和皮下避孕是一种高效而且不错的选择。

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