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多年来已知肝素能引起血小板减少症,但个别病例报导常常没有可靠的指征。作者新近观察2例血栓栓塞患者肝素治疗时出现严重的血小板减少症。例1,女,49岁。有多血质、搔痒和血栓性静脉炎体征。血红蛋白20.7克,血细胞容积62.1%,白细胞13,800,血小板55万,~(51)Cr红细胞容积62毫升/公斤(正常28～32),血浆容积35毫升/公斤(正常38～42)。临床诊断为真性红细胞增多症和深静脉血栓性静脉炎。给予肝素7,500单位静注,每6小时一次。第五天出现肺栓塞,暂时性低血压和右束枝传导阻滞,肺扫描阳性,改肝素7,500单位,每4小时一次。第六天血小板逐渐下降到25,000,
Heparin has been known for many years to cause thrombocytopenia, but reports of individual cases often have no reliable indication. The authors recently observed 2 patients with thromboembolism heparin treatment of severe thrombocytopenia. Example 1, female, 49 years old. There is more blood, itching and thrombophlebitis signs. 20.7 grams of hemoglobin, 62.1% of hematocrit, 13,800 of leucocytes, 550,000 of platelets, 62 ml of erythrocytes of ~ 51 Cr, 28 to 32 of normal, and 35 ml of plasma (normal 38 to 42). Clinical diagnosis of polycythemia vera and deep venous thrombophlebitis. Heparin 7,500 units given intravenously every 6 hours. Pulmonary embolism, temporary hypotension and right bundle branch block appeared on the fifth day, positive lung scan, heparin 7,500 units, once every 4 hours. Platelets gradually dropped to 25,000 on the sixth day,