替罗非班致血小板减少症39例危险因素分析

Risk Factors of Thrombocytopenia Associated with Tirofiban:an Analysis of 39 Cases

目的探讨替罗非班相关血小板减少症发生的影响因素,为安全使用替罗非班提供参考。方法分析2008年5月—2015年7月住院应用盐酸替罗非班治疗非ST段抬高型急性冠脉综合征病人937例,观察入选病人的一般资料、慢性疾病合并状况、血常规、血脂、肾功能等,在应用盐酸替罗非班后复测血常规,了解有无血小板减少症发生,并对危险因素进行分析。结果 937例中发生替罗非班相关血小板减少症39例,发生率为4.16%;其中轻度、中度和重度血小板减少症病人分别为28例(2.99%)、8例(0.85%)和3例(0.32%)。血小板减少组与未减少组比较,年龄、超敏C反应蛋白、用药前血小板、左室射血分数等指标差异有统计学意义(P<0.05)。结论替罗非班所致血小板减少症在临床时有发生,以轻中度为主;在替罗非班应用过程中要考虑病人的年龄、心功能以及基础血小板水平,防止血小板减少症的发生。

Objective To explore the incidence and risk factors of thrombocytopenia induced by tirofiban and to provide information in clinical practice.Methods The patients diagnosed as non ST-elevation acute coronary syndrome（ ACS） and treated with tirofiban were enrolled in the study from May 2008 to July 2015.The data of general information,chronic disease,routine blood test,lipid,renal function were collected and analysis.The incidence and risk factors of thrombocytopenia were assessment and analysis.Results Tirofiban associated thrombocytopenia was identified in 39 cases,the total rate was 4.16%.With mild,moderate and severe thrombocytopenia patients with 28 cases,8 cases and 3cases respectively,the incidence was 2.99%,0.85% and 0.32% respectively.Compared with no thrombocytopenia patients,hypersensitive C-reactive protein,platelet counts before prescription,left ventricular ejection fraction（ LVEF） were selected as risk factors of thrombocytopenia associated with tirofiban（ P〈0.05）.Conclusion It is a relatively common complication of thrombocytopenia induced by tirofiban,and in most cases mainly with mild-to-moderate thrombocytopenia.The age,heart function and basic level of platelet should be considerable in order to reduce the thrombocytopenia during the prescription of tirofiban.