Taberner D A, Thomson J M, Poller L
Br Med J. 1976 Jul 10;2(6027):83-5. doi: 10.1136/bmj.2.6027.83.
A randomised clinical trial was undertaken to compare the value of a factor II, IX, and X concentrate (Prothromplex) with intravenous vitamin K1 (2-5 mg) in reversing an overdose of oral anticoagulants. Rapid partial correction of the prothrombin time, partial thromboplastin time, and the clotting factor assays were observed with the concentrate, but these changes were not always sustained. In contrast vitamin K1 did not show any great effect at two hours but at 24 hours there was always over-correction despite the conservative dosage, prothrombin times being shorter than the therapeutic range. The prothrombin complex concentrate provides a quicker, more controlled but less sustained method of reversing the coumarin defect than vitamin K1. But there remains a significant risk of hepatitis even with a preparation for which strenuous efforts have been made to minimise this risk by screening for hepatitis B virus. The risk should be carefully considered before such concentrates are infused in non-urgent conditions.
开展了一项随机临床试验，比较凝血因子II、IX和X浓缩物（凝血酶原复合物）与静脉注射维生素K1（2 - 5毫克）在逆转口服抗凝剂过量方面的价值。使用浓缩物时，凝血酶原时间、部分凝血活酶时间和凝血因子测定可迅速得到部分纠正，但这些变化并非总能持续。相比之下，维生素K1在两小时时未显示出任何显著效果，但在24小时时，尽管剂量保守，仍总是出现过度纠正，凝血酶原时间短于治疗范围。与维生素K1相比，凝血酶原复合物浓缩物提供了一种更快、更可控但持续时间较短的方法来逆转香豆素缺陷。但即使是一种通过筛查乙肝病毒已竭力将这种风险降至最低的制剂，仍存在显著的肝炎风险。在非紧急情况下输注此类浓缩物之前，应仔细考虑这种风险。
