静脉丙种球蛋白联合血小板输注、利伐沙班治疗肝素诱导的危重血小板减少症1例

doi:10.24920/003462

摘要/Abstract

摘要：

肝素诱导血小板减少症是指应用肝素过程中，以血小板减少，常合并静脉血栓发生为主要表现的疾病，是临床上肝素少见而严重的不良反应。我们使用静脉丙种球蛋白、血小板输注及口服抗凝药利伐沙班成功治疗了1例同时存在血栓与出血表现，肝素诱导的血小板减少症患者。通过对此病例的治疗，我们认为静脉丙种球蛋白输注对危急重肝素诱导的血小板减少症的转归起到关键作用，一方面它避免了血栓的进一步形成；另一方面保证了血小板输注与利伐沙班治疗的有效性。因此，对于危急重肝素诱导的血小板减少症患者，静脉丙种球蛋白输注是一种有效而较优的治疗措施。

关键词: 肝素诱导血小板减少症, 血栓, 静脉丙种球蛋白, 血小板输注, 利伐沙班

Abstract:

Heparin-induced thrombocytopenia (HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in clinical practice. We successfully treated a case of severe HIT presenting with thrombosis and life-threatening bleeding complications with intravenous immunoglobulin (IVIG), platelet transfusion and oral anticoagulant Rivaroxaban. In this case, we considered that IVIG played the most important role by preventing further thrombosis, increasing the platelet count, and ensuring the efficacy of Rivaroxaban. We therefore suggest that IVIG might be the optimal treatment for patients with this urgent condition.

Key words: heparin-induced thrombocytopenia, thrombosis, intravenous immunoglobulin, platelet transfusion, rivaroxaban

Huang He, Lin Ying, Yao Rongxin, He Muqing, Lin Xiaoji. Successful Treatment of Severe Heparin-induced Thrombocytopenia with Intravenous Immunoglobulin, Platelet Transfusion and Rivaroxaban: A Case Report[J].Chinese Medical Sciences Journal, 2019, 34(1): 60-64.

图/表 1

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