不同剂量维生素K_(1)治疗维生素K缺乏性出血患儿的临床效果及对PIVKA-Ⅱ水平、机体营养状况的影响  

Clinical effects of different doses of vitamin K_(1) on children with vitamin K deficiency bleeding and its influences on PIVKA-Ⅱlevel and nutritional status

作　　者：李婷婷 李慧荣 马新凯 陈芳芳 豆峰 LI Tingting;LI Huirong;MA Xinkai;CHEN Fangfang;DOU Feng(the People's Hospital of Yuyang District/Yulin Children's Hospital,Yulin 719000;Xingyuan Hospital of Yulin,Yulin 719000,China)

机构地区：[1]榆阳区人民医院/榆林市儿童医院,陕西榆林719000 [2]榆林市星元医院,陕西榆林719000

出　　处：《临床医学研究与实践》2022年第21期28-31,66,共5页Clinical Research and Practice

基　　金：2021年榆林市青年人才托举计划项目(No.20210319)。

摘　　要：目的对比不同剂量维生素K_(1)治疗维生素K缺乏性出血(VKDB)患儿的临床效果及对凝血酶原前体蛋白(PIVKA-Ⅱ)水平、机体营养状况的影响。方法选取本院收治的90例VKDB患儿作为研究对象,根据随机数表法将其分为A、B、C组,每组30例。A、B、C组分别静脉滴注维生素K_(1)1、2、5 mg。比较三组患儿的凝血功能、凝血因子、PIVKA-Ⅱ水平和异常率以及营养状况。结果治疗第1、5天,三组的凝血功能指标[凝血酶原时间(PT)、部分活化凝血活酶时间(ATPP)、凝血酶因子(TT)]、凝血因子[凝血因子Ⅱ活性(FⅡ∶C)、凝血因子Ⅶ活性(FⅦ∶C)、凝血因子Ⅸ活性(FⅨ∶C)、凝血因子Ⅹ活性(FⅩ∶C)]、PIVKA-Ⅱ水平和异常率均较治疗前明显改善(P<0.05);治疗第5天,三组的凝血功能指标(PT、ATPP)、凝血因子(FⅡ∶C、FⅦ∶C、FⅨ∶C、FⅩ∶C)、PIVKA-Ⅱ水平和异常率均优于治疗第1天(P<0.05);治疗第1天,C组的凝血功能指标(PT、ATPP)、凝血因子(FⅡ∶C、FⅦ∶C、FⅨ∶C、FⅩ∶C)、PIVKA-Ⅱ水平和异常率均明显优于B组和A组,且B组优于A组(P<0.05);治疗第5天,B组和C组的凝血功能指标(PT、ATPP)、凝血因子(FⅡ∶C、FⅦ∶C、FⅨ∶C、FⅩ∶C)、PIVKA-Ⅱ水平和异常率均优于A组(P<0.05),但B组和C组组间比较,差异不显著(P>0.05);治疗第5天,三组的血清白蛋白(ALB)和前白蛋白(PA)水平均明显高于治疗前(P<0.05);治疗第5天,B组和C组的ALB和PA水平均明显高于A组(P<0.05),但B组和C组组间比较,差异无统计学意义(P>0.05)。结论在VKDB的治疗中,建议采用2 mg维生素K_(1),1次/d,共治疗5 d的方案,可显著改善患儿凝血功能指标、凝血因子水平,提升机体营养水平。Objective To compare the clinical effects of different doses of vitamin K_(1) on children with vitamin K deficiency bleeding(VKDB)and its influences on proteins induced by vitamin K absence or antagonism(PIVKA-Ⅱ)level and nutritional status.Methods A total of 90 children with VKDB admitted in our hospital were selected as the research objects and divided into groups A,B and C according to random number table method,with 30 cases in each group.The groups A,B and C were given vitamin K_(1)1,2 and 5 mg intravenously,respectively.The coagulation function,coagulation factor,PIVKA-Ⅱlevel and abnormal rate and nutritional status of the three groups were compared.Results On the 1st and 5th day of treatment,the coagulation function indexes[prothrombin time(PT),activated partial thromboplastin time(ATPP),thrombin time(TT)],coagulation factors[coagulation factorⅡactivity(FⅡ∶C),coagulation factorⅦactivity(FⅦ∶C),coagulation factorⅨactivity(FⅨ∶C),coagulation factorⅩactivity(FⅩ∶C)],PIVKA-Ⅱlevel and abnormal rate in the three groups were significantly improved compared with those befor treatment(P<0.05);on the 5th day of treatment,the coagulation function indexes(PT,ATPP),coagulation factors(FⅡ∶C,FⅦ∶C,FⅨ∶C,FⅩ∶C),PIVKA-Ⅱlevel and abnormal rate in the three groups were better than those on the 1st day of treatment(P<0.05);on the 1st day of treatment,the coagulation function indexes(PT,ATPP),coagulation factors(FⅡ∶C,FⅦ∶C,FⅨ∶C,FⅩ∶C),PIVKA-Ⅱlevel and abnormal rate in the group C were significantly better than those of the group B and the group A,and those in the group B were better than the group A(P<0.05);on the 5th day of treatment,the coagulation function indexes(PT,ATPP),coagulation factors(FⅡ∶C,FⅦ∶C,FⅨ∶C,FⅩ∶C),PIVKA-Ⅱlevel and abnormal rate in the group B and the group C were better than those in the group A(P<0.05),but there were no significant differences between the group B and the group C(P>0.05);on the 5th day of treatment,the levels of seru

关 键 词：维生素K_(1) 维生素K缺乏性出血 凝血因子 

分 类 号：R722.151[医药卫生—儿科]