Qureshi G D, Reinders T P, Swint J J, Slate M B
Arch Intern Med. 1981 Mar;141(4):507-9.
A frequent cause of acquired warfarin resistance is drug interaction; however, ingestion of large amounts of vitamin K in food may also be an etiologic factor. A 31-year-old woman on a weight-reducing diet showed evidence of resistance to warfarin sodium therapy. On a regimen of 35 mg of oral warfarin sodium daily, prothrombin time was 14 s (control, 12 s). Pharmacokinetic studies did not reveal any evidence of impaired adsorption or increased catabolism of the drug. The half-life of her oral warfarin was 26 hours (normal, 15 to 56 hours). Although end-organ resistance was not studied fully, a change of her vegetable-rich, weight-reducing diet (vitamin K content, 1,277 microgram) to a regular diet (vitamin K content, 360 microgram) resulted in substantial reduction in her warfarin resistance. We conclude that in patients on vegetable-rich, weight-reducing diets, a relative resistance to warfarin may be secondary to their increased dietary intake of vitamin K.
获得性华法林抵抗的常见原因是药物相互作用；然而，食物中大量摄入维生素K也可能是一个病因。一名31岁正在进行减肥饮食的女性表现出对华法林钠治疗耐药的迹象。在每日口服35毫克华法林钠的治疗方案下，凝血酶原时间为14秒（对照为12秒）。药代动力学研究未发现药物吸收受损或分解代谢增加的任何证据。她口服华法林的半衰期为26小时（正常为15至56小时）。虽然未充分研究终末器官抵抗，但将她富含蔬菜的减肥饮食（维生素K含量为1277微克）改为常规饮食（维生素K含量为360微克）后，她对华法林的耐药性大幅降低。我们得出结论，对于采用富含蔬菜的减肥饮食的患者，对华法林的相对耐药可能继发于其饮食中维生素K摄入量的增加。
