旧的痕,新的出血:在静止的克罗恩病中重新审视凝血病
Simran Patel1, Ridda Khattak1, Rohan Patel1
1Department of Internal Medicine, Bayhealth Medical Center, Dover, USA.
European journal of case reports in internal medicine
|November 13, 2025
概括
长期的维生素K缺乏会导致克罗恩氏病患者在手术后的几年内出血,即使在缓解期. 及时补充维生素K对于纠正凝血病并预防严重的出血并发症至关重要.
科学领域:
- 医学 医学 医学 医学 医学
- 胃肠病学 胃肠病学
- 血液学 血液学 血液学
背景情况:
- 维生素K对于合成凝血因子II,VII,IX和X至关重要,在血液静止中起着至关重要的作用.
- 缺乏维生素K,一种可溶于脂肪的维生素,在影响营养吸收的慢性胃肠道疾病中很常见.
- 未经治疗的维生素K缺乏会导致严重出血,内出血和骨健康受损.
研究的目的:
- 突出获得的维生素K缺乏是静止克罗恩病患者凝血病的潜在原因.
- 为了强调胃肠道手术的持续的长期营养后果.
- 为了强调对这种患者群体中维生素K缺乏的警的重要性.
主要方法:
- 一个87岁的男性病例报告,有克罗恩氏病和肠切除病史.
- 评估临床表现 (皮肤紫外线) 和实验室发现 (升高的PT和aPTT).
- 评估血清维生素K水平和维生素K依赖的凝血因子的活性.
主要成果:
- 这位患者在克罗恩病和肠切除缓解后的30年内出现紫毛和延长的凝血时间 (PT和aPTT).
- 实验室检测显示,维生素K水平较低,维生素K依赖因子活性降低.
- 在补充维生素K后,凝血病迅速消失.
结论:
- 在患有克罗恩病和凝血病的患者中,应考虑获得的维生素K缺乏症,无论是否有活跃症状或疾病缓解.
- 长期监测脂肪溶性维生素缺乏症对于患有炎症性肠道疾病和胃肠道手术史的患者至关重要.
- 早期识别和补充维生素K可以有效地逆转凝血病并预防出血并发症.
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