中国药物警戒 ›› 2025, Vol. 22 ›› Issue (9): 1045-1048.
DOI: 10.19803/j.1672-8629.20240892

• 安全与合理用药 • 上一篇    下一篇

炔雌醇环丙孕酮片致急性髓系白血病患者血小板减少期间血栓形成2例分析

李舒悦1,2, 邱慧颖3, 吴佳琪1, 高君伟1,*   

  1. 1上海交通大学医学院附属第一人民医院临床药学科,上海 200080;
    2山西省肿瘤医院,中国医学科学院肿瘤医院山西医院药学部,山西 太原 030013;
    3上海交通大学医学院附属第一人民医院血液科,上海 200080
  • 收稿日期:2024-11-18 发布日期:2025-09-22
  • 通讯作者: *高君伟,女,博士,副主任药师,临床药学。E-mail: gjwmhy@163.com
  • 作者简介:李舒悦,女,硕士,药师,临床药学。

Two Cases of Thrombosis Caused by Ethinylestradiol and Cyproterone Acetate Tablets during Thrombocytopenia in Patients with Acute Myeloid Leukemia

LI Shuyue1,2, QIU Huiying3, WU Jiaqi1, GAO Junwei1,*   

  1. 1Department of Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China;
    2Department of Pharmacy, Shanxi Cancer Hospital /Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Taiyuan Shanxi 030013, China;
    3Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
  • Received:2024-11-18 Published:2025-09-22

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摘要： 目的 探讨急性髓系白血病（AML）女性患者在血小板减少期间使用复方口服避孕药（COC）时的血栓发生风险,为此类患者COC安全使用提供参考。方法 分析2例AML患者血小板减少期间服用炔雌醇环丙孕酮片发生的血栓事件,讨论AML患者服用COC时血栓形成的风险因素及监护措施。结果 2例患者发生血栓与COC均有相关性,经及时诊断和处置后转归良好。AML患者常因较低的血小板计数被视为出血高风险患者,但其也具有血液瘀滞、内皮损伤等血栓形成的高危因素,当合并使用COC时,发生颅内静脉窦血栓和深静脉血栓的风险随之增加。结论 临床应重视AML患者使用COC时的静脉血栓形成风险,监测患者凝血指标和症状体征,早期识别,减少血栓发生的风险。

关键词: 炔雌醇环丙孕酮片, 口服避孕药, 急性髓系白血病, 血小板减少, 血栓, 药品不良反应

Abstract: Objective To explore the risk of thrombosis in female patients with acute myeloid leukemia (AML) who use combined oral contraceptives (COCs) during thrombocytopenia so as to provide a reference for safe use of COCs in such patients. Methods The clinical data of two AML patients who developed thrombosis after taking ethinylestradiol and cyproterone acetate tablets during thrombocytopenia was analyzed and the risk factors and monitoring measures for thrombosis in AML patients taking COCs were discussed. Results Thrombosis was correlated with COCs in both patients. After quick diagnosis and treatment, the prognosis was good. AML patients were often considered high-risk for bleeding due to low platelet counts, but they were also at high risk for thrombosis such as blood stasis and endothelial damage. When COCs were used, the risk of cerebral venous sinus thrombosis and deep vein thrombosis increased significantly. Conclusion Clinical pharmacists should be alert to the risk of thrombosis in AML patients using COCs. Coagulation indicators and symptoms of patients should be monitored to detect thrombosis early and reduce the risk.

Key words: Ethinylestradiol and Cyproterone Acetate Tablets, Oral Contraceptives, Acute Myeloid Leukemia, Thrombocytopenia, Thrombosis, Adverse Drug Reactions

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