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急性冠状动脉综合征（ ACS）合并血小板减少症时明显增加患者住院期间出血率和病死率，同时影响ACS治疗。而血小板减少症人群仍有发生血栓事件的可能。血小板减少症患者发生ACS时，血小板计数＜30×109／L时出血概率增加，不宜应用抗血小板药物。当血小板＞30×109／L应用双联抗血小板药物治疗的同时应积极提高血小板治疗，评价出血风险，密切监测血小板变化。如果进行冠状动脉介入治疗建议裸支架治疗。 ACS患者治疗期间出现血小板减少症主要的原因是药物导致血小板减少，包括肝素、血小板糖蛋白Ⅱb／Ⅲa受体拮抗剂、氯吡格雷等，但应及时诊断方能准确治疗，要与弥散性血管内凝血等进行鉴别。“,”The patients with acute coronary syndrome ( ACS ) complicating with thrombocytopenia not only significantly increases the rate of bleeding and mortality during hospitalization but also influences the treatment of ACS.The patients with thrombocytopenia also have the risk of thrombotic event.Thrombocytopenia in patients with ACS should not be given dual antiplatelet medications if platelet count is below 30 ×109/L, because of increased risk of bleeding.When the platelet count is above 30 ×109/L,active platelet therapy should be given,with evaluation of bleeding risk and close monitoring of platelet count change at the same time.The bare metal stent is recommended if coronary stent implantation is needed.The drug induction is the main reason of thrombocytopenia during the treatment of ACS,including heparin, platelet GPⅡb/Ⅲa recep-tor antagonist,clopidogrel etc.,which should be accurately diagnosed for timely treatment,and differentiation from disseminated intravascular coagulation etc.is important.