抗凝血灭鼠剂中毒导致获得性维生素K依赖性凝血因子缺乏症——46例临床分析  

Acquired Deficiency Diseases with Vitamin K-Dependent Coagulation Factor Caused by Anticoagulant Rodenticides Poisoning——Clinical Analysis of 46 Cases

作　　者：王臻[1] 刘忠文[1] 张茵[1] 臧玉柱[1] 杨靖[1] 郭建民[1] 朱尊民[1] 袁晓莉[1] 雷平冲[1] 

机构地区：[1]河南省人民医院血液科,郑州450003

出　　处：《血栓与止血学》2011年第4期166-168,182,共4页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的加深对抗凝血类灭鼠剂中毒的临床认识,以提高诊治水平。方法回顾性分析抗凝血类灭鼠剂中毒导致的获得性维生素K依赖性凝血因子缺乏症的临床特点、疗效和治疗前后凝血功能的改变。结果临床特点以血尿、皮肤黏膜出血为首发症状的多部位出血,经维生素K1治疗后24 h、3 d、7 d检测aPTT、PT和INR与治疗前比较明显缩短(P<0.01),治疗后3 d、7 d检测因子Ⅱ、Ⅶ、IX、X活性与治疗前比较明显增加(P<0.01)。结论维生素K1治疗抗凝血类灭鼠剂中毒导致获得性维生素K依赖性凝血因子缺乏症的剂量要足够、疗程较长。对于不明原因多部位的出血,并有PT、aPTT明显延长者,应考虑抗凝血类灭鼠剂中毒可能。Objective To enhance the understanding of anticoagulant rodenticides poisoning and improve the of.Method To analyse retrospectively the clinical features and laboratory examination and curative effect of vitamin K-dependent coagulation factor（VKDCFs） caused by anticoagulant rodenticides poisoning.Results Hemorrhage in multiple sites,such as hematuria,skin and mucous haemorrhag,was the first symptom of the patients.The aPTT and PT and INR were obviously shortened in the patients at day 1,day 3,day 7 post-treatment（P0.01）compared with those of prior treatment.And the levels of clotting factors Ⅱ,Ⅶ,Ⅸ,Ⅹ were significantly elevated in the patients at day 3,day 7 post-treatment compared with those of prior treatment（P 0.01）.Conclusion When unexplained hemorrhage in multiple sites accompanying with much prolonged PT and aPTT,VKDCFs caused by anticoagulant rodenticides poisoning should be taken into account.And the long term and sufficient dose of vitamin K is needed for the treatment.

关 键 词：获得性 维生素K依赖性凝血因子 灭鼠剂中毒 

分 类 号：R979.8[医药卫生—药品]