Arnesen H, Smith P
Red Cross Clinic, Oslo, Norway.
Thromb Res. 1991 Feb 1;61(3):311-4. doi: 10.1016/0049-3848(91)90108-9.
To evaluate the effect of PIVKA (Proteins Induced by Vitamin K Absence or Antagonism) on the bleeding tendency during oral anticoagulation, we studied consecutive patients intensively treated with warfarin (INR greater than 4.8). The level of anticoagulation was measured with the PIVKA-insensitive Normotest (NT) as well as with the PIVKA-sensitive Thrombotest (TT), and the results are expressed as per cent coagulant activity. The NT/TT ratio was determined. Twenty patients with bleeding episodes had a mean NT/TT ratio of 2.06 as compared to 2.20 in 143 patients without bleeding episodes (p = 0.08). As the NT/TT ratio was not higher in patients with bleedings, we conclude that PIVKA are of no importance for bleeding during anticoagulation with vitamin K antagonists.
为评估维生素K缺乏或拮抗诱导蛋白（PIVKA）对口服抗凝治疗期间出血倾向的影响，我们对接受华法林强化治疗（国际标准化比值大于4.8）的连续患者进行了研究。使用对PIVKA不敏感的正常凝血酶原时间测定法（NT）以及对PIVKA敏感的凝血酶试验（TT）来测量抗凝水平，结果以凝血活性百分比表示。确定了NT/TT比值。20例有出血发作的患者的平均NT/TT比值为2.06，而143例无出血发作的患者为2.20（p = 0.08）。由于出血患者的NT/TT比值并不更高，我们得出结论，PIVKA在维生素K拮抗剂抗凝治疗期间对出血无重要影响。
