Correction of INR by prothrombin complex concentrate and vitamin K in patients with warfarin related hemorrhagic complication
Correction of INR by prothrombin complex concentrate and vitamin K in patients with warfarin related hemorrhagic complication
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DOI：
10.1016/s0049-3848(02)00402-4
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发表时间：
2002-10-01
影响因子：
7.5
通讯作者：
Naritomi, H
中科院分区：
文献类型：
--
作者：
Yasaka, M;Sakata, T;Naritomi, H
我们研究了17名在华法令治疗期间出现严重出血并发症的患者中，凝血酶原复合物浓缩物（PCC，中位数500 IU）和维生素K（10-20 mg）或其中一种对凝血和临床结果的影响。入院时国际标准化比值（INR）中位数为2.7 11例患者经PCC和维生素K治疗后，INR降至中位数1.13（0.91-1.36）给药后10分钟，凝血因子II、VII、IX的血浆水平升高，两例患者在服用PCC后INR突然下降，但在12-24 h后又升高，同时凝血因子水平下降。其中1例患者在给药后12-24小时出现脑血肿扩大，INR再次升高。INR从2.69缓慢下降（1.03-3.35）至1.28（1.25-1.44）12-PCC与维生素K或不与维生素K一起给药似乎更有效，快速纠正增加的INR水平比维生素K治疗无PCC。PCC不含维生素K可能导致INR再次升高和临床恶化。(C)2002爱思唯尔科技有限公司版权所有。
We investigated the effect of prothrombin complex concentrate (PCC, median 500 IU) and vitamin K (10-20 mg) or either on blood coagulation and clinical findings in 17 patients with major hemorrhagic complication during warfarin treatment. Their international normalized ratio (INR) at admission was median 2.7 (2.0-above 10.0).In 11 patients treated with PCC and vitamin K, INR decreased to median 1.13 (0.91-1.36) 10 min after the administration with elevation of plasma levels of coagulant factors II, VII, IX, X and protein C.INR decreased abruptly after the administration of PCC without vitamin K in two patients but it increased again 12-24 h after, with decrease of coagulant factors levels. In one of them, a hematoma of the brain enlarged with INR re-increase 12-24 h after the administration.In four patients treated with vitamin K alone, INR decreased slowly from 2.69 (1.03-3.35) to 1.28 (1.25-1.44) 12-24 h after the administration in parallel with gradual increase of the coagulant factors.PCC administration with or without vitamin K seems to be more effective in rapidly correcting increased INR levels than vitamin K treatment without PCC. PCC without vitamin K may result in re-increase of INR and clinical deterioration. (C) 2002 Elsevier Science Ltd. All rights reserved.