Vogel J J, de Moerloose P, Bouvier C A, Gaspoz J, Riant P
Département de médecine, Hôpital cantonal universitaire, Genève.
Schweiz Med Wochenschr. 1988 Dec 17;118(50):1915-7.
In 1985 and 1986 the Swiss Toxicologic Information Center registered 152 cases of rodenticide poisoning. Among those substances chlorophacinone, an indanedione derivative, has a prolonged antivitamin K effect. We report here the case of an eighteen-year-old female hospitalized 3 days after deliberately ingesting some 100 mg chlorophacinone. Her Quick time at admission was less than 10% (Prothrombin time 79 sec., normal control 12 sec.). Under high dose vitamin K therapy the Quick was rapidly corrected but fell again on each vitamin K withdrawal. In a search for a relation between the variations of prothrombin time and chlorophacinone plasma levels, these were assessed by HPLC. Prothrombin time (and vitamin K dependent factors VII and X) finally normalized only 7 weeks after chlorophacinone ingestion. Clinical condition remained satisfactory throughout and other biological parameters unaffected. This case emphasizes the need for prolonged clinical and laboratory follow-up for rodenticide intoxications and for vitamin K administration for several weeks.
1985年和1986年，瑞士毒物信息中心登记了152例杀鼠剂中毒病例。在这些物质中，茚满二酮衍生物氯鼠酮具有延长的抗维生素K作用。我们在此报告一例18岁女性病例，她在故意摄入约100毫克氯鼠酮3天后住院。入院时她的凝血酶原时间比值低于10%（凝血酶原时间79秒，正常对照12秒）。在高剂量维生素K治疗下，凝血酶原时间比值迅速得到纠正，但每次停用维生素K后又会再次下降。为了寻找凝血酶原时间变化与氯鼠酮血浆水平之间的关系，通过高效液相色谱法对其进行了评估。摄入氯鼠酮7周后，凝血酶原时间（以及维生素K依赖因子VII和X）最终恢复正常。整个临床状况一直令人满意，其他生物学参数未受影响。该病例强调了对杀鼠剂中毒进行长期临床和实验室随访以及给予数周维生素K的必要性。
