Thoracic Sugery, Department of Clinical Sciences, Lund University, Skane University Hospital, 22184 Lund, Sweden.
Anaesthesia & Intensive Care, Department of Clinical Sciences, Lund University, Skane University Hospital, 22184 Lund, Sweden.
Nutrients. 2021 Jul 27;13(8):2580. doi: 10.3390/nu13082580.
The aim of this study was to evaluate the effects of vitamin K1 on various vitamin K-dependent proteins in critically ill patients with prolonged Owren PT. We included critically ill non-bleeding adult patients without liver failure or anticoagulation treatment, with Owren PT > 1.2, who were prescribed intravenous vitamin K1. Blood was drawn at baseline and at 20-28 h after vitamin K1 administration. At both time points, we measured various vitamin K-dependent proteins and coagulation assays. ClinicalTrials.gov; Identifier: NTC3782025. In total, 52 patients were included. Intravenous vitamin K1 reduced Owren PT, Quick PT, protein induced by vitamin K absence/antagonist-II and desphospho-uncarboxylated matrix Gla protein (dp-ucMGP), but not to normal levels. Concomitantly, there were increases in thrombin generation and the activity of coagulation factors II, VII, IX and X that was only counteracted with a small increase in Protein C activity. In conclusion, the results suggest that vitamin K1 strengthens coagulation as measured by PT decrease and increases in the activity of vitamin K-dependent clotting factors and thrombin generation. The decreased dp-ucMGP, and its potential positive short- and long-term non-coagulative effects, merits further research.
本研究旨在评估维生素 K1 对伴有 Owren PT 延长的危重症患者各种维生素 K 依赖性蛋白的影响。我们纳入了无肝衰竭或抗凝治疗、Owren PT > 1.2 的非出血成年危重症患者，并给予静脉注射维生素 K1。在基线和维生素 K1 给药后 20-28 小时采血。在两个时间点，我们测量了各种维生素 K 依赖性蛋白和凝血测定。ClinicalTrials.gov；标识符：NTC3782025。共纳入 52 例患者。静脉注射维生素 K1 降低了 Owren PT、Quick PT、维生素 K 缺乏/拮抗剂 II 诱导蛋白和去羧基未羧化基质 Gla 蛋白（dp-ucMGP），但未达到正常水平。同时，凝血酶生成和凝血因子 II、VII、IX 和 X 的活性增加，仅伴随着蛋白 C 活性的小幅增加而得到拮抗。总之，结果表明，维生素 K1 通过 PT 降低和维生素 K 依赖性凝血因子和凝血酶生成活性的增加来增强凝血。dp-ucMGP 的减少及其潜在的短期和长期非凝血作用值得进一步研究。
