肝素诱导的重度血小板减少症并咯血1例

Heparin-Induced Severe Thrombocytopenia with Hemoptysis:A Case Report

目的肝素诱导的血小板减少症(HIT)是应用肝素后出现的一种罕见的、较为严重的药物不良反应。使用肝素后患者出现HIT的发病率约为0.2%,一般在肝素使用后5~14天开始,血栓栓塞形成等并发症风险明显增加。方法本文分析1例下肢动脉闭塞患者在使用低分子肝素治疗过程中多次出现血小板减少的临床资料,并结合相关文献进行复习,结果分析HIT的发病机制、临床特征、诊断依据及防治措施。结论通过整个诊疗过程,明确抗凝方案选择。

Objective Heparin-induced thrombocytopenia(HIT)is a rare and serious adverse drug reaction after heparin administration.The incidence of HIT in patients after heparin treatment is about 0.2%.Generally,the risk of thromboembolism and other complications increases significantly from 5 to 14 days after heparin treatment.Methods The clinical data of a case of thrombocytopenia in patients with lower extremity arterial occlusion treated with low molecular weight heparin were analyzed,and the related literatures were reviewed.Results The pathogenesis,clinical characteristics,diagnostic basis and prevention and treatment measures of HIT were analyzed.Conclusion Through the whole process of diagnosis and treatment,the choice of anticoagulation program is clear.