Ⅱ型肝素诱导血小板减少症危险因素分析.docVIP

Ⅱ型肝素诱导血小板减少症危险因素分析 　　摘 要 目的：分析我院心内科患者发生II型肝素诱导血小板减少症的危险因素。方法：收集筛选我院心内科自2004年1月―2013年7月间使用肝素抗凝治疗过程中产生II型肝素诱导的血小板减少症的病例进行临床资料分析，根据使用肝素后血小板数减少的比例以50%为界，将患者分为明显减少组和未明显减少组。主要分析指标为性别、年龄、肝素制剂、肝素治疗时间、合并使用抗血小板药物、使用肝素前血小板计数、内生肌酐清除率、丙氨酸转氨酶以及谷氨酸转氨酶。结果：131例患者中使用肝素类型为普通肝素（介入手术过程中使用）和低分子肝素，其中血小板明显减少为32例，血小板未明显减少为99例。统计结果显示年龄和用药前血小板计数存在统计学差异。结论：年龄和用药前血小板计数可能为II型肝素诱导产生血小板减少的危险因素。 　　关键词 血栓 肝素诱导血小板减少 危险因素 　　中图分类号：R973.2； R595.4 文献标识码：A 文章编号：1006-1533（2016）09-0046-03 　　Analysis of risk factors of heparin-induced thrombocytopenia 　　ZHENG Yu1， WANG Qibing2， LI Xiaoye1（1. Department of Pharmacy， 2. Department of Cardiology， Zhongshan Hospital， Fudan University， Shanghai 200032， China） 　　ABSTRACT Objective： To investigate the risk factors of type II heparin-induced thrombocytopenia. Methods： The clinical data from type II heparin-induced thrombocytopenia cases occurred during the anticoagulation therapy from January， 2004 to July， 2013 in department of cardiology of our hospital were collected and analyzed. All the patients were divided into a significant thrombocytopenia group （thrombocytopenia over 50%） and an inconspicuous thrombocytopenia group（thrombocytopenia under 50%）. Some indicators were analyzed， such as gender， age， heparin dosage forms， time for heparin treatment， the combined use of antiplatelet drugs， platelet count before heparin treatment， clearance rate of creatinine， alanine transaminase and glutamic pyruvic transaminase. Results： An unfractionated heparin or a low molecular weight heparin was used in 131 cases of patients， in which there were 32 cases as significant thrombocytopenia and 99 cases as inconspicuous thrombocytopenia. The statistical results showed that age and platelet count before treatment were significantly different. Conclusion： The age and platelet count before medication may be the risk factors for type II heparin-induced thrombocytopenia. 　　KEY WORDS thrombosis； heparin-induced thrombocytopenia； risk factors 　　肝素诱导的血小板减少症（heparin induced thr