Plasma levels of factors II, VII and X and their relationship to the international normalized ratio during chronic Warfarin therapy

被引:69
作者
Lind, SE
Callas, PW
Golden, EA
Joyner, KA
Ortel, TL
机构
[1] UNIV VERMONT,DEPT PATHOL,BURLINGTON,VT 05405
[2] UNIV VERMONT,DEPT BIOMETRY,BURLINGTON,VT
[3] FLETCHER ALLEN HLTH CARE,DEPT PATHOL,BURLINGTON,VT
[4] DUKE UNIV,MED CTR,DEPT MED,DURHAM,NC 27710
[5] DUKE UNIV,MED CTR,DEPT PATHOL,DURHAM,NC 27710
关键词
international normalized ratio; factor II; factor VII; factor X; Warfarin; anticoagulation;
D O I
10.1097/00001721-199701000-00008
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Monitoring of oral anticoagulant therapy is usually undertaken with the prothrombin time (PT), which is influenced Ly factors II, X, and VII. A number of studies have suggested that the prothrombin (factor II) level may be the most important determinant of the therapeutic efficacy of these drugs. Although some studies suggest that oral anticoagulants induce a similar residual level of plasma vitamin K-dependent proteins, others have called this into question. We therefore measured plasma levels of factors II, X, and VII in 50 patients undergoing chronic Warfarin therapy. The plasma levels of factors II, X, and VII were significantly different. Although the factor X levels of all plasmas mere < 30%, levels of factors II and VII were > 30% in 14% and 50% of the samples, respectively. Multivariable analysis showed factor II levels to be the least significant of the three factors measured in determining the international normalized ratio of plasma or whole blood. Thus, plasma levels of the vitamin K-dependent coagulation factors are not equal in patients on chronic Warfarin therapy. If factor II (prothrombin) levels are indeed the major determinants of the therapeutic efficacy of Warfarin, alternative means of monitoring that more accurately reflects prothrombin levels should be evaluated.
引用
收藏
页码:48 / 53
页数:6
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