O'Brien D P, Shearer M J, Waldron R P, Horgan P G, Given H F
Department of Surgery, University College Hospital, Galway, Ireland.
J R Soc Med. 1994 Jun;87(6):320-2. doi: 10.1177/014107689408700607.
Eleven patients with cholestatic jaundice had measurements of plasma vitamin K1 performed. Seven of these 11 (64%) had subnormal levels. The prothrombin time (PT) was prolonged in three of 15 patients with cholestasis (20%), the patient with the longest PT had the lowest vitamin K1 level. A single intramuscular (im) dose of 10 mg vitamin K1 lowered the PT in 9/15 patients (includes correcting the three prolonged PTs). The initial mean plasma vitamin K1 level rose 24 h later, to a mean plasma level which was 33 times the upper limit of the normal physiological range. These preliminary results suggest that a majority of patients presenting with cholestatic jaundice have low tissue reserves of vitamin K1, and that guidelines for vitamin K1 therapy in patients with cholestatic jaundice should be revised.
对11例胆汁淤积性黄疸患者进行了血浆维生素K1测定。这11例患者中有7例(64%)维生素K1水平低于正常。15例胆汁淤积患者中有3例(20%)凝血酶原时间(PT)延长,PT最长的患者维生素K1水平最低。单次肌肉注射10mg维生素K1可使15例患者中的9例PT降低(包括纠正3例延长的PT)。24小时后,初始平均血浆维生素K1水平升高,达到正常生理范围上限的33倍的平均血浆水平。这些初步结果表明,大多数胆汁淤积性黄疸患者维生素K1的组织储备较低,胆汁淤积性黄疸患者维生素K1治疗指南应予以修订。