长期服用华法林的患者骨密度降低。
Reduced bone density in patients on long-term warfarin.
机构信息
Department of Rheumatology, Mashhad University of Medical Sciences, Mashhad, Iran.
出版信息
Int J Rheum Dis. 2009 Jul;12(2):130-5. doi: 10.1111/j.1756-185X.2009.01395.x.
AIM
Vitamin K is an essential factor for carboxylation of bone matrix protein. Low vitamin K may be associated with reduced bone mineral density (BMD). The issue of whether long-term sodium warfarin therapy as oral anticoagulant that antagonizes vitamin K, results in decreased bone density, is controversial. Our purpose in this study was to assess the effects of warfarin on BMD.
METHODS
We performed a case control study survey of bone density in 70 patients with rheumatic valvular heart disease 'mechanical valve replacement' on long-term warfarin compared with 103 randomly selected matched controls.
RESULTS
There was a marked reduction in BMD (g/cm(2)) and T-score of lumbar spine between patients and controls (P = 0.048, 0.005). Duration of warfarin use was the only risk factor of significant importance respectively on spinal T-score (P < 0.03).
CONCLUSIONS
Screening of patients on long-term warfarin for reduced bone density should be considered. We strongly suggest the prophylactic use of calcium-vitamin D supplements for these patients.
目的
维生素 K 是羧化骨基质蛋白的必需因素。维生素 K 水平低可能与骨密度降低有关。长期使用华法林作为拮抗维生素 K 的口服抗凝剂是否会导致骨密度降低，这是一个有争议的问题。我们本研究的目的是评估华法林对骨密度的影响。
方法
我们对 70 例风湿性心脏瓣膜病“机械瓣膜置换术”患者长期服用华法林的骨密度进行了病例对照研究，并与 103 例随机选择的匹配对照进行了比较。
结果
患者与对照组之间腰椎 BMD（g/cm(2)）和 T 评分明显降低（P = 0.048，0.005）。华法林使用时间是脊柱 T 评分的唯一重要危险因素（P < 0.03）。
结论
应考虑对长期服用华法林的患者进行骨密度降低筛查。我们强烈建议对这些患者预防性使用钙-维生素 D 补充剂。
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