Kumar R, Marwaha N, Marwaha R K, Garewal G
Division of Pediatric Hematology-Oncology, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh-160012.
Indian J Pediatr. 2001 Mar;68(3):235-8. doi: 10.1007/BF02723197.
The study was undertaken to determine the frequency of occurrence of vitamin K deficiency in infants with diarrhoeal illness. Infants were categorized into four groups as follows: A(acute diarrhoea), B(protracted diarrhoea) C(intractable diarrhoea) and D(healthy controls). Screening coagulation tests, PT and PTTK along with estimation of functional activity and total antigenic levels of prothrombin were performed. The ratio of functional to total prothrombin was calculated. PT was prolonged in 30% (24/75) of all infants with diarrhoea as compared to controls where the abnormality was observed in 11.1% infants (2/18). The ratio of functional to total prothrombin was significantly lower in infants with diarrhoea, the mean +/- SD values being 0.65 +/- 0.41 vs 1.1 +/- 0.26. This difference was statistically highly significant (p < 0.001). Low ratio was observed in 57.3% (43/75) infants with diarrhoea. Thus functional to total prothrombin ratio identified approximately twice as many diarrhoeal infants with vitamin K deficiency as compared to PT alone. There was no significant correlation with breast feeding as the only mode of diet, or the prior administration of antibiotics in infants with diarrhoea. The inherent malabsorptive state in diarrhoea may be a major contributory factor.
开展这项研究是为了确定腹泻病婴儿中维生素K缺乏症的发生率。婴儿被分为以下四组:A组(急性腹泻)、B组(迁延性腹泻)、C组(难治性腹泻)和D组(健康对照)。进行了筛查凝血试验、PT和PTTK,以及凝血酶原功能活性和总抗原水平的测定。计算了功能性凝血酶原与总凝血酶原的比率。与对照组相比,所有腹泻婴儿中有30%(24/75)的PT延长,对照组中11.1%的婴儿(2/18)出现异常。腹泻婴儿中功能性凝血酶原与总凝血酶原的比率显著较低,平均值±标准差分别为0.65±0.41和1.1±0.26。这种差异在统计学上具有高度显著性(p<0.001)。75例腹泻婴儿中有57.3%(43/75)的比率较低。因此,与单独使用PT相比,功能性凝血酶原与总凝血酶原的比率发现维生素K缺乏的腹泻婴儿数量大约是其两倍。腹泻婴儿中,仅母乳喂养这一饮食方式或先前使用抗生素与维生素K缺乏无显著相关性。腹泻时固有的吸收不良状态可能是一个主要促成因素。