Ishii F, Iizuka B, Nakanishi T, Nagasako K, Hayashi N
Department of Gastroenterology, Tokyo Women's Medical College.
Nihon Shokakibyo Gakkai Zasshi. 1997 Jun;94(6):389-97.
Vitamin K deficiency caused by antituberculous agents was examined in clinical patients and in experimental rats. When antituberculous agents given to the patients who had only total elental diet because of small intestinal dysfunction, a marked increase in plasma PIVKA-II and a decrease in thrombo-test value were observed. These changes were quickly normalized by administration of vitamin K, despite of succeeding or stopping of antituberculous agents. In rat experiments, effects of four agents (ethambutol, isoniazid, paraaminosalicylate, and rifampicin) on prothrombin time were studied. Among these agents, only rifampicin prolonged prothrombin time. This prolongation depended on drug doses and duration of administration. In addition to this hypoprothrombinemia, an increase in plasma PIVKA-II was also observed, and these changes were normalized within 24 hours of vitamin K administration. These data suggest that rifampicin inhibits vitamin K epoxide reductase interfering re-use of vitamin K and caused vitamin K deficiency in patients with total elental diet.
在临床患者和实验大鼠中研究了抗结核药物引起的维生素K缺乏症。当给因小肠功能障碍仅接受全肠内营养饮食的患者使用抗结核药物时，观察到血浆异常凝血酶原-II显著增加，血栓试验值降低。尽管继续或停止使用抗结核药物，但通过给予维生素K，这些变化迅速恢复正常。在大鼠实验中，研究了四种药物（乙胺丁醇、异烟肼、对氨基水杨酸和利福平）对凝血酶原时间的影响。在这些药物中，只有利福平延长了凝血酶原时间。这种延长取决于药物剂量和给药持续时间。除了这种低凝血酶原血症外，还观察到血浆异常凝血酶原-II增加，并且在给予维生素K后24小时内这些变化恢复正常。这些数据表明，利福平抑制维生素K环氧化物还原酶，干扰维生素K的再利用，并导致全肠内营养饮食患者维生素K缺乏。
