杀鼠药中毒所致凝血功能障碍20例临床分析  

Clinical analysis of 20 patients with coagulation disorder induced by rodenticide poisoning

作　　者：孟景晔[1] 骆子义[1] 朱惠敏[1] MENG Jingye;LUO Ziyi;ZHU Huimin(Department of Haematology,The Third People＇s Hospital of Shenzhen,Shenzhen,Guangdong 518112,China)

机构地区：[1]深圳市第三人民医院血液科,广东深圳518112

出　　处：《安徽医药》2018年第10期1892-1894,共3页Anhui Medical and Pharmaceutical Journal

基　　金：深圳市科技创新委资助项目(20150327204626)

摘　　要：目的总结杀鼠药中毒导致的凝血功能障碍的临床诊断及治疗。方法对20例抗凝血杀鼠药中毒致凝血功能障碍患者予以维生素K_1治疗,比较患者治疗前后的凝血功能改变:凝血酶原时间(PT)、国际正常化比率(INR),活化部分凝血活酶时间(APTT)、凝血因子Ⅱ、Ⅶ、Ⅸ、Ⅹ活性。结果 20例患者全部治愈,治疗前后凝血功能明显改变,PT治疗前后分别为:(103.2±20.3)s,(12.0±0.5)s。INR治疗前后分别为:4.2±2.4,1.4±0.2。APTT治疗前后分别为:(93.2±25.4)s,(30.2±3.4)s。凝血因子Ⅱ:活性成分治疗前后分别为:(6.2±2.5)%,(92.3±4.5)%。凝血因子Ⅶ:活性成分治疗前后分别为:(10.8±4.9)%,(86.2±3.4)%。凝血因子Ⅸ:活性成分治疗前后分别为:(22.5±6.8)%,(96.4±7.8)%。凝血因子X:活性成分治疗前后分别为:(14.2±3.2)%,(83.2±3.4)%,差异有统计学意义(P<0.001)。结论杀鼠药中毒致凝血功能障碍,容易误诊,维生素K_1是特效解毒药。Objective To summarize the clinical diagnosis and therapeutic methods about disturbance of blood coaguation induced by rodenticide poisoning. Methods Twenty patients were treated with vitamin K1,the changes of coagulation funCTion before and after treatment including prothrombin time（ PT）,international normalization ratio（ INR）,aCTivated partial thromboplastin time（ APTT）,and coagulation faCTor Ⅱ,Ⅶ,Ⅸ,Ⅹ aCTivity were compared. Results All the patients were cured. There was obvious difference between before and after treatment in the blood clotting index（ P〈0. 001）. Before and after treatment,PT was（ 103. 2 ± 20. 3） s,（ 12 ± 0. 5） s respeCTively; INR was（ 4. 2 ± 2. 4）,（ 1. 4 ± 0. 2）,respeCTively; APTT was（ 93. 2 ± 25. 4） s,（ 30. 2 ± 3. 4） s,respeCTively; Ⅱ： C was（ 6. 2 ± 2. 5） %,（ 92. 3 ± 4. 5） %,respeCTively; Ⅶ： C was（ 10. 8 ± 4. 9） %,（ 86. 2 ± 3. 4） %,respeCTively; Ⅸ： C was（ 22. 5 ± 6. 8） %,（ 96. 4 ± 7. 8） %,respeCTively; Ⅹ： C was（ 14. 2 ± 3. 2） %,（ 83. 2 ± 3. 4） %,respeCTively,and the differences were statistically significant（ P〈0. 001）. Conclusions Coagulation disorder induced by rodenticide poisoning is easy to misdiagnose,the therapy with vitamin K1 is a specific antidote.

关 键 词：中毒 香豆素类 苯茚二酮 血液凝固因子 维生素K1 

分 类 号：R595.4[医药卫生—内科学]