肝素诱导血小板减少症临床研究

Clinical Study of Heparin Induced Thrombocytopenia

目的探讨普通肝素(UFH)和/或低分子肝素(LMWH)抗凝时所致肝素诱导血小板减少症(HIT)的临床诊断和治疗。方法回顾性分析应用UFH和/或LMWH抗凝时所致HIT患者5例的临床表现、治疗及预后。结果 976例患者应用UFH和/或LMWH出现5例HIT,其中应用UFH患者2例,应用LMWH患者1例,应用UFH和LMWH患者2例。血小板下降幅度均>50%.所有患者均立即停用UFH和/或LMWH,改为磺达肝癸钠抗凝。血小板恢复正常时间为6~17d,随访6个月,5例患者均未出现血栓栓塞及严重出血并发症。结论HIT是肝素治疗中少见但严重的并发症,应用时需常规检测血小板计数,早期诊断和正确治疗。

Objective To study the clinical diagnosis and treatment of heparin induced thrombocytopenia（ HIT} caused by un- fraetionated heparin （UFH） and/or low molecular weight heparin （LMWH） antieoagulating. Methods Retrospectively analyzed the clinical manifestations, treatment and prognosis in 5 cases patients of HIT caused by UFH and/or LMWH anticoagulating. Results Five cases HIT in 976 patients used UFH and/or MWH,2 male cases,3 female cases ;2 cases applicated UFH, l case applicated LMWH,2 cases applicated UFH and/or LMWH. Platelets were reduced more than 50%. All the patients were immediately stop using UFH and/or LMWH,instead by Fondaparinux sodium injection. Platelet recovery normal time for 6 - 17d,this 5 patients were followed up for 6 months, no complications of thromboembolism and severe bleeding. Conclusion HIT is a rare but serious complication of heparin therapy, routine monitoring platelet count can get early diagnosis and proper treatment to reduce mortality and morbidity.