盐酸替罗非班致严重血小板减少症1例

A cases of severe thrombocytopenia induced by tirofiban

1病例资料患者,女,78岁,因胸闷痛1h入院,既往有糖尿病和高血压病史,血糖和血压控制理想,2009年与2010年分别行前降支（LAD）、左回旋支（LCX）和右冠状动脉（RCA）PCI术。入院时心电图示窦性心律,Ⅱ、Ⅲ、aVF、V3R-V5RST段抬高0.1~0.2mV,肝肾功能、心肌酶正常,肌钙蛋白I（cTnI）28.42ng/ml,诊断：1冠状动脉粥样硬化性心脏病急性ST段抬高型心肌梗死（下壁＋右室）.

Summary Tirofiban is a kind of platelet glycoprotein Ⅱ b/Ⅲa （GP Ⅱ b/Ⅲa） receptor antagonist, which combines the platelet membrane GP Ⅱ b/Ⅲ a receptor and affects the final common pathway of platelet aggrega- tion. The major side-effects of tirofiban are bleeding and thrombocytopenia. The patient occurred severe thrombo- cytopenia after using tirofiban, the number of platelets returned to normal after discomtinvation of tirofiban. Routine count of platelets can detect tirofiban-induced thrombocytopenia drug using tirofiban treatment. Tirofiban should be stopped immediately when thrombocytopenia occurred in order to avoid adverse events.