Decreased Warfarin Effect after Initiation of High-Protein, Low-Carbohydrate Diets
Decreased Warfarin Effect after Initiation of High-Protein, Low-Carbohydrate Diets
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开始高蛋白、低碳水化合物饮食后华法林效果降低
DOI：
10.1345/aph.1e454
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发表时间：
2005
影响因子：
2.9
通讯作者：
Jennifer L. Rodis
中科院分区：
文献类型：
--
作者：
Stuart J. Beatty;B. Mehta;Jennifer L. Rodis
目的：报告2例开始高蛋白、低碳水化合物饮食后国际标准化比率(INR)降低的病例。病例摘要：病例1。一位67岁的白人妇女因静脉血栓栓塞症接受华法林治疗3年。在开始高蛋白、低碳水化合物饮食后，患者需要增加22.2%的华法林剂量(从45毫克/周增加到57.5毫克/周)。她的INR在8周内保持在这个剂量的治疗范围内。当患者停止高蛋白、低碳水化合物饮食时，需要减少到最初的华法林剂量，才能恢复治疗性INR。病例2。一名58岁的白人男子因脑血管意外接受华法林治疗已有8年。开始高蛋白、低碳水化合物饮食导致华法林剂量增加30%(从26.25毫克/周增加到37.5毫克/周)。在他停止高蛋白、低碳水化合物饮食后，他的华法林剂量减少到了原来的剂量。讨论：Naranjo概率量表表明华法林饮食和高蛋白饮食之间可能存在不良影响。高蛋白饮食已被证明能提高血清白蛋白水平。这可能会导致更多的华法林与血清白蛋白结合，从而降低华法林的抗凝作用。白蛋白的增加在开始高蛋白饮食后迅速出现，并似乎立即影响华法林的抗凝治疗。结论：这些病例表明高蛋白、低碳水化合物饮食和华法林治疗之间存在显著的相互作用。接受华法林治疗的患者应该接受华法林治疗和高蛋白、低碳水化合物饮食的潜在相互作用的教育和监测。
OBJECTIVE: To report 2 cases of decreased international normalized ratio (INR) after initiation of a high-protein, low-carbohydrate diet. CASE SUMMARIES: Case 1. A 67-year-old white woman had been receiving warfarin for 3 years for venous thromboembolism. After initiation of a high-protein, low-carbohydrate diet, the patient required a 22.2% increase (from 45 to 57.5 mg/wk) in warfarin dose. Her INR remained in the therapeutic range on this dose for 8 weeks. When the patient stopped the high-protein, low-carbohydrate diet, a decrease back to the original warfarin dose was required to return to a therapeutic INR. Case 2. A 58-year-old white man had been receiving warfarin for 8 years for a cerebrovascular accident. Initiation of a high-protein, low-carbohydrate diet resulted in a 30% increase (from 26.25 to 37.5 mg/wk) in warfarin dose. His warfarin dose was reduced to the original dose after he stopped the high-protein, low-carbohydrate diet. DISCUSSION: The Naranjo probability scale indicated a possible adverse effect between warfarin and high-protein diets. High-protein diets have been shown to increase serum albumin levels. This may result in more warfarin binding to serum albumin, thereby decreasing the anticoagulant effect of warfarin. The increase of albumin occurs rapidly after initiation of a high-protein diet and appears to promptly affect anticoagulation therapy with warfarin. CONCLUSIONS: These cases indicate a significant interaction between high-protein, low-carbohydrate diets and warfarin therapy. Patients receiving warfarin therapy should be educated on and monitored for the potential interaction that occurs with warfarin therapy and high-protein, low-carbohydrate diets.
高蛋白、高碳水化合物和高脂肪饮食对实验室参数的影响。
影响因子：
3.5
作者：
Fagan,TC;Oexmann,MJ
通讯作者：
Oexmann,MJ