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1例64岁男性右股骨粗隆间粉碎性骨折患者因术前出现肺栓塞和双下肢血栓，给予那屈肝素钙4 100 U皮下注射、1次/d抗凝治疗。用药前患者血小板计数（PLT）166×10n 9/L。使用那屈肝素钙5 d后，将其剂量增至4 100 U皮下注射、1次/12 h。增加剂量后第8天实验室检查示PLT升至800×10n 9/L。诊断：血小板增多症，考虑与那屈肝素钙有关。停用该药，改用利伐沙班20 mg口服，1次/d。换药5 d后，PLT降至590×10n 9/L；换药34 d后，PLT 297×10n 9/L。n “,”A 64-year-old male patient with comminuted intertrochanteric fracture of right femur received subcutaneous injection of 4 100 U nadroparin calcium once daily for anticoagulant treatment due to pulmonary embolism and thrombosis of both lower limbs before operation. His platelet count (PLT) was 166×10n 9/L before the treatment. After 5 days of treatment, the dose of nadroparin calcium was increased to 4 100 U once per 12 h. On the 8th day after the dose increase, the patient′s PLT increased to 800×10n 9/L. Thrombocytosis was diagnosed, which was considered to be related to nadroparin calcium. The drug was stopped and replaced by rivaroxaban 20 mg once daily orally. Five days later, the patient′s PLT decreased to 590×10n 9/L; 34 days later, PLT was 297×10n 9/L.n