Acquire Prothrombin Complex Deficiency

posted on 25 Apr 2013 22:34 by ononmedicine in diesease
ภาวะพร่องโปรธรอมบิน คอมเพล็กซ์ (Acqu ire Prothrombin Complex Deficiency: APCD หรือIdiopathic Vitamin K Deficiency in Infancy : IVKDI)
เป็นโรคเลือดออกง่ายที่เกิดจากการมีโปรธรอมบิน คอมเพล็กซ์ (Prothrombin Complex) ต่ำโปรธรอมบิน
คอมเพล็กซ์เป็นพลาสมาโปรตีนเกี่ยวกับปัจจัยการแข็งตัวของเลือด ชนิด คือ แฟคเตอร์ II, VII. IX, X 
 เกิดจากการขาดวิตามินเค
 
ทารกแรกเกิดทั่วไป ควรได้รับการเสริมด้วยวิตามินเค เพื่อป้องกันการเกิดโรค hemorrhagic disease of the new born (HDN) วิตามินเคจะช่วยในการสร้าง coagulation factor (2,7,9,10) หรือ prothrombin complex
ซึ่งวิตามินเคจะค่อยๆลดหลังจากทารกแรกเกิด นอกจากนั้นน้ำนมแม่ยังไม่เพียงพอต่อความต้องการของทารกและแบคทีเรียในลำไส้ของทารกยังสร้างวิตามินเคได้ไม่ดี 
ดังนั้นจึงควรให้วิตามินเค1  ฉีดเข้ากล้ามเนื้อขนาด 0.5-1.0 มิลลิกรัมหรือให้รับประทานทางปาก 1-2 มิลลิกรัม
 
ส่วนใหญ่มีอาการเลือดออกในสมองซึม กระสับกระส่าย ร้องกวน ไม่ดูดนม อาเจียน ไม่ค่อยรู้สึกตัว ชัก หมดสติ กระหม่อมด้านหน้าโป่งตึง อัมพาต หรือเสียชีวิตได้
อัตราการเกิดโรคนี้ในประเทศไทย จากรายงานของกองระบาดวิทยา กระทรวงสาธารณสุข พ.ศ. 2526 พบว่า เกิดขึ้นได้ในเด็กทารกในอัตรา 1 ต่อ 2,857 หรือ 35 ต่อแสนคน โดยมีอัตรา ตายสูงถึงร้อยละ 52 สาเหตุใหญ่อาจเนื่องมาจากได้รับวิตามินเคไม่เพียงพอ โดยเฉพาะอย่างยิ่งเด็กทารกที่กินนมแม่ที่มีวิตามินเคน้อย

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