Division of Hematology and Thromboembolism, McMaster University Faculty of Health Sciences, St Joseph's Hospital, 50 Charlton Ave. East, Hamilton, Ontario, Canada.
Thromb Haemost. 2010 Jul;104(1):118-21. doi: 10.1160/TH09-12-0822. Epub 2010 May 10.
Unanticipated elevation of the INR is common in patients receiving warfarin. We performed a prospective cohort study of 107 warfarin-treated patients with INR values of more than 10 who received a single 2.5 mg dose of oral vitamin K. During the first week, one patient experienced major bleeding, and one died. In the first 90 days after enrolment four patients had major bleeding (3.7%, 1.0% to 9.3%), eight patients (7.5%, 3.3% to 14.2%) died and two had objectively confirmed thromboembolism. Based on our low rate of observed major bleeding we conclude that 2.5 mg of oral vitamin K is a reasonable treatment for patients with INR values of more than 10 who are not actively bleeding.
服用华法林的患者的 INR 升高并不少见。我们对 107 名 INR 值超过 10 的接受华法林治疗的患者进行了一项前瞻性队列研究，这些患者单次接受了 2.5 毫克的口服维生素 K。在第一周内，1 名患者发生大出血，1 名患者死亡。在入组后的前 90 天内，4 名患者发生大出血（3.7%，1.0%至 9.3%），8 名患者（7.5%，3.3%至 14.2%）死亡，2 名患者发生客观证实的血栓栓塞。根据我们观察到的大出血发生率较低，我们得出结论，2.5 毫克口服维生素 K 是 INR 值超过 10 且无活动性出血的患者的合理治疗方法。
