Booth S L, Centurelli M A
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA.
Nutr Rev. 1999 Sep;57(9 Pt 1):288-96. doi: 10.1111/j.1753-4887.1999.tb01815.x.
Warfarin has been successfully used in the medical management of thromboembolic disease for nearly six decades. It is widely assumed that a dietary vitamin K-warfarin interaction exists. To avoid this potential interference with the efficacy of warfarin in stable anticoagulation, patients typically receive instructions to consume a constant dietary intake of vitamin K. While dark, green vegetables are primary sources of dietary vitamin K, these foods are not commonly consumed on a daily basis in the United States. However, there still exists dietary resistance to warfarin that is attributable to vitamin K. Based on food analysis studies on vitamin K, it is now known that dietary vitamin K is found in certain plant oils and prepared foods containing these plant oils, such as baked goods, margarines, and salad dressings. The preparation of foods with vitamin K-rich oils may also contribute to a diet-warfarin interaction, although this has yet to be confirmed in a clinical trial. A dose-response of vitamin K on the effect of warfarin anticoagulation has not yet been established. However, there are sufficient data to suggest that a constant dietary intake of vitamin K that meets current dietary recommendations of 65-80 micrograms/day is the most acceptable practice for patients on warfarin therapy. Vitamin K composition data for commonly consumed foods are now available and may facilitate successful anticoagulation for patients being treated with warfarin.
华法林已成功用于血栓栓塞性疾病的药物治疗近六十年。人们普遍认为饮食中维生素K与华法林存在相互作用。为避免这种对华法林在稳定抗凝治疗中疗效的潜在干扰，患者通常会收到关于保持饮食中维生素K摄入量恒定的指示。虽然深色绿叶蔬菜是饮食中维生素K的主要来源，但在美国这些食物并非每日都普遍食用。然而，仍存在因维生素K导致的对华法林的饮食抵抗。基于对维生素K的食物分析研究，现在已知饮食中的维生素K存在于某些植物油以及含有这些植物油的预制食品中，如烘焙食品、人造黄油和沙拉酱。用富含维生素K的油制备食物也可能导致饮食与华法林的相互作用，尽管这一点尚未在临床试验中得到证实。维生素K对华法林抗凝效果的剂量反应尚未确定。然而，有足够的数据表明，对于接受华法林治疗的患者，保持饮食中维生素K的摄入量恒定，达到目前每天65 - 80微克的饮食建议量，是最可接受的做法。现在已有常见食物的维生素K成分数据，这可能有助于接受华法林治疗的患者成功进行抗凝治疗。
