糖蛋白Ⅱb/Ⅲa受体拮抗剂——替罗非班致急性血小板减少1例

Glucoprotein Ⅱb/Ⅲa receptor antagonists,tirofiban induced acute thrombocytopenia in 1 patient

1名45岁的女性患者,因不稳定心绞痛接受冠状动脉造影及介入治疗,术前14天,开始规律口服阿司匹林100mgqd,氯吡格雷75mgqd,同时连续皮下注射低分子肝素7天。术中应用盐酸替罗非班(Ⅱb/Ⅲa受体拮抗剂)和普通肝素,术后1h,血小板下降至3×109·L-1,并伴有阴道出血。停用以上药物并予丙种球蛋白、血小板输注后4日,血小板恢复至正常水平,推测替罗非班是最可能导致血小板下降的药物。

Forty-five-year-old woman with unstable angina pectoris received coronary arteriongraphy and percutaneous coronary intervention （PCI）. The patient was treated with asprin 100 mg and clopidogrel 75 mg once daily from 14 days before PCI. Meanwhile low molecular heparin was injected subcutaneously for 7 days. GP Ⅱb/Ⅲa receptor antagonist tirofiban and heparin were given during PCI. Just 1 hour after PCI, the patient presented vaginal bleeding and then we found the platelet number decreased to 3×10^9·L^-1. All drugs mentioned above were stopped immediately. The patient was treated with gamma globulin and platelet infusion. After 4 days, the platelet counting recovered to normal level. We consider that the tirofiban maybe the initiated factor of acute thrombocytopenia.