Shetty H G, Backhouse G, Bentley D P, Routledge P A
Department of Clinical Pharmacology, Llandough Hospital, Penarth, South Glamorgan, United Kingdom.
Thromb Haemost. 1992 Jan 23;67(1):13-5.
Reversal of the anticoagulant effect of warfarin in patients with no active haemorrhage can be achieved by administration of intravenous vitamin K1. Currently recommended doses of intravenous vitamin K1, for this purpose often result in subsequent difficulties in anticoagulation. We observed the response to low dose intravenous vitamin K1 in patients requiring reversal of anticoagulant therapy. Ten consecutive patients received 1 mg and 21 further patients received 0.5 mg of intravenous vitamin K1. In 50% of the patients who received 1 mg of vitamin K1 the INR (International Normalised Ratio) fell below 2 at 24 h whereas in patients who received 0.5 mg the INR fell below 5.5 in all subjects after 24 h and in none did it fall below 2.0. No patient had any thrombotic or haemorrhagic complications and no difficulty was encountered in re-establishing anticoagulant control after 24 h. We recommend 0.5 mg of vitamin K1 as an effective and convenient method of predictable and fine control of oral anticoagulant therapy.
对于无活动性出血的华法林抗凝患者，静脉注射维生素K1可逆转其抗凝作用。目前为此目的推荐的静脉注射维生素K1剂量，常常会导致后续抗凝出现困难。我们观察了需要逆转抗凝治疗的患者对低剂量静脉注射维生素K1的反应。连续10例患者接受了1毫克静脉注射维生素K1，另有21例患者接受了0.5毫克静脉注射维生素K1。接受1毫克维生素K1的患者中，50%在24小时时国际标准化比值（INR）降至2以下，而接受0.5毫克的患者在24小时后所有受试者的INR均降至5.5以下，且无一例低于2.0。没有患者出现任何血栓形成或出血并发症，24小时后重新建立抗凝控制也未遇到困难。我们推荐0.5毫克维生素K1作为一种有效且方便的方法，用于可预测和精细控制口服抗凝治疗。
