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饮食中维生素K的摄入量与香豆素类抗凝治疗的稳定性:来自一项临床试验的证据。

Dietary vitamin K intake and stability of anticoagulation with coumarins: evidence derived from a clinical trial.

作者信息

Zuchinali P, Souza G C, de Assis M C S, Rabelo E R, Rohde L E

机构信息

Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.

出版信息

Nutr Hosp. 2012 Nov-Dec;27(6):1987-92. doi: 10.3305/nh.2012.27.6.6068.

DOI:10.3305/nh.2012.27.6.6068
PMID:23588449
Abstract

BACKGROUND

Dietary vitamin K intake has been considered a major factor that influences stability of oral anticoagulation (OA) with coumarins. Few studies have evaluated the relationship between amounts of dietary vitamin K intake and stability of anticoagulation.

OBJECTIVE

To assess whether high dietary vitamin K intake is associated to stability of International Normalized Ratio (INR) of the prothrombin time.

METHODS

We performed a sub-analysis of a randomized clinical trial involving outpatients from the anticoagulation clinic of a university hospital. INR and vitamin K intake were prospectively collected at baseline, 15, 30, 60 and 90 days after randomization. Patients were considered with a stable anticoagulation when their INR coefficient of variation was less than 10%. Dietary vitamin K intake was assessed by a food frequency questionnair and a score of intake was derived.

RESULTS

We studied 132 patients on chronic OA (57 ± 13 years; 55% males); 23 patients (17%) were achieved stable anticoagulation. Stable and unstable patients had no significant differences in baseline characteristics. The dietary vitamin K score over the entire follow-up for stable patients was significantly lower than that for unstable patients (p = 0.012).

DISCUSSION

Our findings suggest that INR stability could be achieved with relatively low amounts of dietary vitamin K.

摘要

背景

膳食维生素K摄入量一直被认为是影响香豆素类口服抗凝治疗(OA)稳定性的主要因素。很少有研究评估膳食维生素K摄入量与抗凝稳定性之间的关系。

目的

评估高膳食维生素K摄入量是否与凝血酶原时间国际标准化比值(INR)的稳定性相关。

方法

我们对一项涉及大学医院抗凝门诊门诊患者的随机临床试验进行了亚分析。在随机分组后的基线、15、30、60和90天前瞻性收集INR和维生素K摄入量。当患者的INR变异系数小于10%时,认为其抗凝稳定。通过食物频率问卷评估膳食维生素K摄入量,并得出摄入量评分。

结果

我们研究了132例接受慢性OA治疗的患者(57±13岁;55%为男性);23例患者(17%)实现了稳定抗凝。稳定组和不稳定组患者的基线特征无显著差异。稳定患者在整个随访期间的膳食维生素K评分显著低于不稳定患者(p = 0.012)。

讨论

我们的研究结果表明,相对较低的膳食维生素K摄入量即可实现INR稳定。

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Dietary vitamin K intake and stability of anticoagulation with coumarins: evidence derived from a clinical trial.饮食中维生素K的摄入量与香豆素类抗凝治疗的稳定性:来自一项临床试验的证据。
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Patients with unstable control have a poorer dietary intake of vitamin K compared to patients with stable control of anticoagulation.与抗凝控制稳定的患者相比,控制不稳定的患者维生素K的饮食摄入量较差。
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Medicine (Baltimore). 2016 Mar;95(10):e2895. doi: 10.1097/MD.0000000000002895.
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Vitamin K for improved anticoagulation control in patients receiving warfarin.
维生素K用于改善接受华法林治疗患者的抗凝控制。
Cochrane Database Syst Rev. 2014 May 15;2014(5):CD009917. doi: 10.1002/14651858.CD009917.pub2.