摘要
1例68岁男性患者因慢性心房颤动长期服用华法林抗凝治疗11年,其国际标准化比值被控制在1.5~2.3间。2个月前患者被诊出罹患直肠癌,术后口服卡培他滨化疗,但在第3个化疗疗程内出现全身皮肤淤斑、左侧背部皮下血肿等症状,国际标准化比值也升高至5.2。经停用华法林、给予维生素K1治疗后,皮肤淤斑和皮下血肿消退。华法林抗凝作用增强可能与卡培他滨抑制细胞色素P450 2C9同功酶的活性有关。
A 68 years old man has received warfarin therapy for chronic fibrillation atria for 11 years, and his international normalized ratio（INR） was maintained between 1.5 ~ 2.3. This patient began to receive capecitabine chemotherapy due to resected rectal cancer two months ago. During the third cycle of the chemotherapy, he found ecchymoma on his left back, and ecchymoses on his skin all over the body, and his INR increased to 5.2. Ecchymoma and ecchymoses gradually regressed after withdraw of warfarin and administration of vitamin K1. The enhanced anticoagulant effect of warfarin might be associated with the capecitabine-induced suppression of cytochrome P450 2C9 isoenzyme.
出处
《上海医药》
CAS
2015年第7期72-72,76,共2页
Shanghai Medical & Pharmaceutical Journal
