单用第三代头孢菌素联合维生素K1对尿毒症患者血浆凝血酶原时间的影响  

Effect of third-generation cephalosporin used alone or combined with vitamin KI on prothrombin of uremic patients

作　　者：严宁[1] 周玉坤[1] 李康峰[1] 

机构地区：[1]第二军医大学长征医院南京分院肾内科,南京210015

出　　处：《临床肾脏病杂志》2014年第4期218-221,共4页Journal Of Clinical Nephrology

摘　　要：目的观察单用第三代头孢菌素与第三代头孢菌素联合维生素K1同时使用对尿毒症患者血浆凝血酶原时间（prothrombin time，PT）的影响。方法21例尿毒症患者因感染入院，入院后以随机数字表法分组，分为A组和B组。A组患者11例，男7例，女4例，采集单独使用第三代头孢菌素治疗前、治疗后（使用头孢地嗪2．0g，每日1次静脉滴注；或头孢哌酮舒巴坦钠2．0g，每日2次静脉滴注）第4天晨起空腹静脉血2份；B组患者10例，男3例，女7例，在使用第三代头孢菌素治疗同时使用维生素K110mg肌肉注射，每日2次；采集治疗前、治疗后（使用头孢地嗪2．0g，每日1次静脉滴注；或头孢哌酮舒巴坦钠2．0g，每日2次静脉滴注）第4天晨起空腹静脉血2份；均为凝固法测定PT值。结果A组治疗后IrI＂值与治疗前比较，差异有统计学意义（P〈0．05）。结果显示，A组治疗后第4天PT值显著延长；B组治疗后PT值与治疗前比较，差异无统计学意义（P〉0．05）。结果显示，B组治疗后第4天PT值无明显延长。A组治疗后PT增加值与B组治疗后PT增加值比较，差异有统计学意义（P〈0．05）。结果显示，尿毒症患者感染性疾病采用第三代头孢菌素同时加用维生素K1治疗，可明显减少PT值延长。结论单用第三代头孢菌素治疗感染可弓I起亚临床维生素K缺乏，表现为PT值增加，而使用第三代头孢菌素治疗的同时使用维生素K1则可使此种情况得到明显改善。Objective To analyze the effect of third-generation cephalosporin used alone or com- bined with vitamin K1 on prothrombin of uremic patients. Methods Twenty-one patients with uremia caused by infection were randomly divided into two groups. The 11 patients in group A （7 men and 4 women） were only given the thir＆generation cephalosporin treatment. Two copies of venous blood were collected from each patient before the third-generation cephalosporin treatment and at the fourth day after using cefodizime （2 g, once daily, intravenous infusion） or using the cefoperazon sodium and sulbactam sodium （2 g, twice daily, intravenous infusion）. The 10 patients in group B （3 men and 7 women） were given the third-generation cephalosporin treatment and vitamin K1 （10 mg, intramuscu- lar injection, twice daily）. Two copies of venous blood from each patient were collected before the treatment and at the fourth day after using the cefodizime （2 g, once daily, intravenous infusion） or using the cefoperazon sodium and sulbactam sodium （2 g, twice daily, intravenous infusion）. The solidification method was applied to determine the prothrombin time （PT）. Results The changes in PT value before and after the treatment in group A showed statistically significant difference （P〈0. 05）. At fourth day after treatment, PT value in group A was significantly prolonged. The changes in PT value before and after the treatment in group B showed no statistically significant difference. At fourth day after treatment, PT value in group B was not prolonged. There was statistically significant differ-ence in the increased PT value between groups A and B after treatment （P〈0. 05）. The combined use of the third-generation cephalosporins with vitamin K1 to treat the infected illness in uremic patients could significantly reduce the PT value. Conclusions Using the third-generation cephalosporin to treat the infected illness can cause the subclinical vitamin K deficiency, showing the increased PT value in- crease

关 键 词：尿毒症 维生素 治疗 

分 类 号：R978.11[医药卫生—药品]