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首页> 外文期刊>Journal of the American Academy of Nurse Practitioners. >The use of vitamin K supplementation to achieve INR stability: A systematic review and meta-anaiysis
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The use of vitamin K supplementation to achieve INR stability: A systematic review and meta-anaiysis

机译：补充维生素K达到INR稳定性的系统评价和荟萃分析

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Purpose: Systematically review and quantitatively synthesize evidence on use of oral vitamin K supplementation in reducing international normalized ratio (INR) variability.Data sources: PubMed, The Cochrane Library, PsycINFO, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Turning Research Into Practice (TRIP), Web of Science were searched for studies meeting predetermined inclusion/exclusion criteria. Five studies meeting criteria (three randomized trials, one quasi-experimental pre-post study, one retrospective case series) were appraised for quality and data synthesized by two reviewers. Pooled effect size of time in INR therapeutic range (TTR) was estimated using random effects meta-analysis.Conclusions: Pooled effect size representing data from four studies (678 subjects) was 0.31, 95% confidence interval 0.03-0.59 (Cochran Q = 7.1; p = .07; I2 = 57.8) and favored vitamin K supplementation. Given wide variability among individual studies, there is not enough evidence to advise for or against the routine use of vitamin K supplementation to achieve INR stability. However, evidence does suggest that it may be of some benefit for some patients with INR instability.Implications for practice: There is insufficient evidence to support routine supplementation with vitamin K in patients on chronic anticoagulation therapy but select patients, particularly those with persistent INR instability despite known adherence to regimen and no dietary or drug-drug interactions, may benefit from the intervention. Future research is warranted.
机译：目的：系统地审查和定量综合使用口服维生素K补充剂以减少国际标准化比例（INR）变异的证据在Web of Science的Into Practice（TRIP）中，搜索了符合预定纳入/排除标准的研究。评估了5项符合标准的研究（3项随机试验，一项准实验前研究，一项回顾性病例系列），其质量和数据由两名审核者进行了评估。结论：随机效应荟萃分析估计了INR治疗时间（TTR）中的合并效应时间大小。结论：合并效应大小代表来自四项研究（678名受试者）的数据为0.31，95％置信区间为0.03-0.59（Cochran Q = 7.1） ; p = .07; I2 = 57.8），并建议补充维生素K。鉴于个别研究之间存在很大差异，因此没有足够的证据建议或反对常规使用维生素K补充剂以达到INR稳定。但是，确实有证据表明它对某些INR不稳定的患者可能有一定益处。实践意义：尚无足够的证据支持接受慢性抗凝治疗的患者常规补充维生素K，但选择的患者特别是INR持续不稳定的患者尽管已知遵循治疗方案且没有饮食或药物相互作用，但仍可从干预中受益。未来的研究是必要的。

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