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目的肝素相关性血小板减少症是由于抗肝素-血小板因子4复合物抗体形成所致,多发生于肝素应用开始后5～14 d,但也可发生于停止使用肝素后3周左右,早期监测血小板并加以识别可降低发病率和病死率。方法回顾性分析2008～2010年内科应用肝素治疗患者停止肝素后发生肝素相关性血小板减少症患者10例的临床资料,并对相关文献进行复习。结果肝素相关性血小板减少症可发生严重的病症和潜在病死率增加,本组10例死亡1例,治愈9例。6例发生血栓形成。结论对怀疑肝素相关性血小板减少症患者应及时停止肝素,多数患者血小板可回复正常;约50%的患者可发生血栓事件。患者可接受非肝素抗凝治疗,早期发现及时处理可减少发病率和病死率。
Purpose Heparin-associated thrombocytopenia is due to the formation of anti-heparin-platelet factor 4 complex antibodies that occurs 5 to 14 days after the start of heparin but may also occur about 3 weeks after heparin is discontinued. Early monitoring of platelets And identify it to reduce morbidity and mortality. Methods The clinical data of 10 patients with heparin-related thrombocytopenia who had heparin after stopping heparin treatment during 2008-2010 were retrospectively analyzed. The related literatures were reviewed. Results Heparin-related thrombocytopenia may occur serious illness and increased mortality, 10 patients died in this group, 9 cases were cured. Thrombosis occurred in 6 cases. Conclusion In patients with suspected heparin-related thrombocytopenia, heparin should be stopped promptly, and most patients can return to normal platelets. Thrombosis may occur in about 50% of patients. Patients can receive non-heparin anticoagulation therapy, early detection of timely treatment can reduce morbidity and mortality.