血液透析应用肝素诱发血小板减少症两例报道

Heparin-induced Thrombocytopenia in Hemodialysis: A Report of Two Cases

本文报告两例血液透析患者因使用肝素诱发血小板减少症(HIT)的临床表现及处理经过,阐述HIT的发病机制和分型、临床诊断、治疗与预防措施的特殊性,指出透析患者使用肝素抗凝时出现无法解释的血小板减少或伴有血栓形成,提示可能存在HIT;停用肝素是控制HIT的最基本措施;阿加曲班可作为此类患者血透抗凝时首选的替代药物。

This paper reports the clinical manifestations and treatment efforts of heparin -induced thrombocytopenia （HIT） in two patients undergoing hemodialysis.The literature on pathogenesis, classification, diagnosis, and treatment and pre-vention measures of HIT is also reviewed.This report suggests that the possibility of HIT should be considered when unexplained platelet decrease accompanied by thrombosis occurs in patients undergoing hemodialysis .It also indicates that termination of hepa-rin administration and use of argatroban as an alternative anticoagulation agent are effective measures to manage HIT developed during hemodialysis.