肝素诱导的血小板减少症并发血栓形成的治疗进展

Advances in therapy for heparin- induced thrombocytopenia complicated by thrombosis

给予肝素治疗患者中，在肝素诱导的血小板减少症（HIT）的发生率约为1％，而HIT常可致灾难性血栓形成和血栓栓塞并发症（HITT），包括肺栓塞、缺血性肢体坏死、急性心肌梗死（AMI）和中风。此文对HITI＂的最佳治疗策略给予讨论。有证据表明，。肾功能正常的HI’rr患者应给予阿加曲班或来匹卢定或达那肝素治疗，而肾功能不全的HITF患者应给予阿加曲班治疗。虽然有给H11Tr患者输注血小板无疑是“火上加油”和增加血栓形成危险的广泛报道，但并没有直接证据能够证明HITT患者输注血小板后可增加血栓形成的风险。

For patients receiving heparin in whom clinicians consider the risk of heparin - induced thrombocytopenia （HIT） to be 〉 1%, HIT can lead to devastating thromboembolic complications （HITT）, including pulmonary embolism, ischemic limb necrosis, acute myocardial infarction, and stroke. This article offers recommendations on optimal management strategical of HITT. In patients with HITT who have normal renal function, suggest the use of argatroban or lepirudin or danaparoid. In patients with HI＇IT and renal insufficiency, suggest the use of argatroban. It has been widely reported that giving a platelet transfusion to a patient with HITT ＂adds fuel to the fire＂ and increases the risk of thrombosis. There is no direct evidence supporting an increased risk of thrombosis in patients with HI＇IT who are given platelet transfusions.