Kiyota Takashige, Shiota Seiji, Hamanaka Ryosuke, Tsutsumi Daisuke, Takakura Takeshi, Miyazaki Eishi
Department of General Medicine, Almeida Memorial Hospital, Oita 870-1195, Japan.
Department of General Medicine, Oita University Faculty of Medicine, Yufu 879-5593, Japan.
Case Rep Med. 2019 Jan 23;2019:4917856. doi: 10.1155/2019/4917856. eCollection 2019.
An 83-year-old man under warfarin therapy presented for assessment of prolonged prothrombin time and cough. High-resolution computed tomography findings of the chest showed diffuse alveolar hemorrhage. His international normalized ratio (INR) was 11.89. He had been treated with rifampicin for a persistent infection, but this had been discontinued about two months before admission. Rifampicin suppresses the anticoagulant activity of warfarin, which can lead to a need for increased doses of warfarin to achieve and maintain a therapeutic INR. More frequent INR monitoring is needed even after discontinuing rifampicin.
一名正在接受华法林治疗的83岁男性因凝血酶原时间延长和咳嗽前来评估。胸部高分辨率计算机断层扫描结果显示弥漫性肺泡出血。他的国际标准化比值（INR）为11.89。他曾因持续性感染接受利福平治疗，但在入院前约两个月已停药。利福平会抑制华法林的抗凝活性，这可能导致需要增加华法林剂量以达到并维持治疗性INR。即使停用利福平后，也需要更频繁地监测INR。
