【摘要】 目的 研究不明原因获得性维生素K(vitamin K,VitK)依赖凝血因子缺乏症（acquired deficiency of vitamin K dependent coagulation factors,ADVKDCF）患者临床和检测结果特点、治疗方法、转归及病因，提高该类疾病的认知和诊疗水平。方法 回顾性研究2019年3月至2021年3月中南大学湘雅二医院21例不明原因及26例常见类型ADVKDCF患者临床特征、实验室检查结果和治疗方法，并跟踪其转归。结果 不明原因ADVKDCF患者因出血症状就诊，可通过凝血酶原时间比部分活化凝血酶原时间更早也更延长进行ADVKDCF初步判断；以VitK依赖凝血因子活性检测或VitK治疗性诊断进行确证；另纤维蛋白原和肝功能均正常。治疗以VitK补充为主，其临床特征和转归与灭鼠药中毒相似，病情易反复。结论 不明原因ADVKDCF应考虑灭鼠药中毒的可能，VitK的补充需及时、足量和足程。更多还原

【Abstract】 Objective The clinical and test characteristics,treatment methods,prognosis,and possible etiology of patients with unexplained acquired deficiency of vitamin K-dependent coagulation factors(ADVKDCF)were analyzed to improve the understanding and treatmentin the patients. Methods The clinical features,laboratory test results and treatment methods of 21 patients withunexplained ADVKDCF and 26 patients with common ADVKDCF in the Second Xiangya Hospital of Central South University from March 2019 to March 2021 were retrospctively studied,and their prognosis were tracked.Results ADVKDCF can be preliminatively determined by prothrombin time being earlier and longer than partially activated prothrombin time in patients with unexplained ADVKDCF who come to hospital due to bleeding symptoms. Then,ADVKDCF can be confirmed by vitamin K-dependent coagulation factors activity detection or vitamin K therapeutic diagnosis finally. In addition,fibrinogen and hepatic function were normal. Vitamin K supplement was the main treatment,and the clinical characteristics and prognosisof patients with unexplained ADVKDCF were like those of ADVKDCF patients caused by rodenticide poisoning. Conclusion Unexplained ADVKDCF should consider the possibility of rodenticide poisoning,and vitamin K should be supplemented in time,in sufficient amount and for sufficient duration.更多还原