他汀类药物引起血小板减少不良反应分析

Analysis of adverse effects of statins on thrombocytopenia

目的探究他汀类药物引起血小板减少的临床特征、发生原因及治疗措施。方法以"他汀""血小板减少"为检索词,检索Pub Med、万方数据库,对患者的一般情况、既往病史及用药史、临床表现及检验指标、药物用法用量与血小板减少出现时间、联合用药、治疗与转归等进行分析。结果共纳入15篇文献,合计17例患者。广泛紫癜、黏膜出血、鼻衄、牙龈出血、血小板减少是他汀类药物致血小板减少的的主要临床症状。用药至发病最短时间为30 min,最长3年。经停药、肾上腺皮质激素、输注血小板等治疗后均痊愈。结论密切观察应用他汀类药物患者的临床表现及生化指标检测结果,他汀类药物广泛应用于各类慢病,患者年龄较大,且有易造成脑出血风险。因此用药时应从小剂量开始,联合应用时更应权衡利弊,密切观察患者的各类指标。

Objective To investigate the clinical features and causes of thrombocytopaenia induced by statins,and provide the preventive measures. Methods Pub Med,Wanfang Database were retrieved by using the key words of statins and thrombocytopaenia in Chinese and English,respectively. The baseline characteristics of the patients,the situation of drug use,the clinical manifestations,the drug-related analysis,the outcome of treatment and prognosis were analyzed. Results There were 15 cases reports referred to 17 patients suffering hrombocytopaenia induced by statins. Widespread purpura,mucosal hemorrhage,epistaxis,gingival bleeding,and thrombocytopenia were the main clinical symptoms of statins to reduce platelets.The shortest time from medication to onset is 30 minutes and up to 3 years. After discontinuation of medication,adrenocorticotropic hormone,infusion of platelets,all of them recovered. Conclusion The clinical performance and biochemical test results of statins patients should be closely observed. Statins are widely used in various types of chronic diseases. The patients are older and are at risk of cerebral hemorrhage. Therefore,the use of drugs should be started from a small dose,and the combined use should weigh the advantages and disadvantages,and closely observe the various indicators of patients