肝素和利奈唑胺致冠心病PCI术后严重血小板减少1例分析

Serious Thrombocytopenia Induced by Heparin and Linezolid in a CAD Patient after PCI

目的:关注肝素和利奈唑胺致血小板减少的不良反应及处理方法。方法:通过分析临床病例资料,探讨不良反应发生原因,从而提出临床工作中的药学监护事项。结果:该患者出现的严重血小板减少可能与肝素诱导的免疫反应和利奈唑胺有关,根据不良反应关联性评价,与该2药存在可能相关性。结论:对于术中、术后应用肝素又合并感染的老年患者,应加强监护,尤其是加强血小板计数的监测,如出现血小板减少,在排除其他药物作用的情况下,应高度怀疑肝素诱导的血小板减少症,给予正确处理。

OBJECTIVE： To alert the physicians and pharmacists to pay close attention to the adverse drugs reaction of thrombocytopenia induced by heparin and linezolid and resolutions. METHODS： The causes of adverse drug reactions were investigated by analyzing clinical cases to put forward the pharmaceutical care matters in the clinic. RESULTS： Serious thrombocytopenia may be concern with the immunoreaction induced by heparin and linezolid. Adverse drug reaction was possible correlated with the hepa- tin and linezolid, according to the adverse reaction correlation evaluation. CONCLUSIONS： We should strengthen pharmaceutical care for the elderly patients with infection receiving heparin during and after operation, especially monitoring the platelet count. If they suffer from thrombocytopenia, physicians and pharmacist should doubt HIT highly, and give correct disposal.