van Amstel W J, Boekhout-Mussert M J, Loeliger E A
Blut. 1978 Feb;36(2):89-93. doi: 10.1007/BF00996835.
Successful prevention of the progression of incipient hemorrhagic skin necrosis by timely administration of vitamin K1 in a woman treated with phenprocoumon is presented. From a critical review of the literature strong evidence emerges that coumarin necrosis does only occur in cases with severe initial drug induced hypocoagulability. Non- recognition thusfar of its importance is due to insufficient knowledge of the biological activities of thromboplastin preparations presently used in the laboratory control of oral anticoagulation. All well documented cases with apparently adequate Quick values were monitored with Faktor VIII insensitive thromboplastin. Therefore, such preparations should no longer be used in anticoagulant control.
本文介绍了在一名接受苯丙香豆素治疗的女性中，通过及时给予维生素K1成功预防早期出血性皮肤坏死进展的案例。通过对文献的批判性回顾发现，强有力的证据表明香豆素坏死仅发生在严重初始药物诱导的低凝状态的病例中。迄今为止对其重要性的忽视是由于目前在口服抗凝实验室控制中使用的凝血活酶制剂的生物学活性知识不足。所有凝血酶原时间（Quick值）明显正常的记录良好的病例均使用对凝血因子VIII不敏感的凝血活酶进行监测。因此，此类制剂不应再用于抗凝控制。
