肝素诱导的血小板减少症.pptVIP

肝素诱导的血小板减少症演示文稿当前1页，总共41页。 （优选）肝素诱导的血小板减少症当前2页，总共41页。 Epidemiologythe chance of significant exposure to heparin exceeds 50% in hospitalized patientsacute coronary syndrome (UA / MI)pulmonary embolismdeep venous thrombosis and prophylaxisatrial fibrillation / strokeheparinized pulmonary wedge cathetersPCIIABPSemi Thromb Hemost 1999;25 Suppl 1:57-60当前3页，总共41页。 U.S. Estimated Causes of Accidental Deaths〈 100040,00090,000Deaths per year当前4页，总共41页。 Medication Errors – Hospital Audit%REFERENCE当前5页，总共41页。 血小板减少症（HIT/HITS） 美国每年有1200万人因肢体或肺部血栓、心脏病或血管成型术而接受肝素治疗36万人发生HIT12万人出现血栓并发症（静脉、动脉）3.6万人死亡 当前6页，总共41页。 Heparin-induced ThrombocytopeniaHeparin-induced thrombocytopenia (HIT), an antibody-mediated syndrome, is associated with significant morbidity and mortalityconsidered a rarity in the pastunrecognized by many cliniciansdiagnoses can be difficult to confirmuntil recently there was no therapeutic options other than discontinuation of heparin当前7页，总共41页。 Epidemiologythrombocytopenia is one of the most common laboratory abnormalities found among hospitalized patientsserologically proven HIT occurs in 1.5% to 3% of patients with heparin exposureN Engl J Med 1995;332:1330-5当前8页，总共41页。 Cascade of events leading to formation of HIT antibodies and prothrombotic components当前9页，总共41页。 Bleeding and Clottingthe most feared consequence in these patients with a low platelet count is not bleeding but clottingpresent with mucocutaneous bleeding, ranging from petechiae and ecchymoses to life-threatening gastrointestinal and intracranial hemorrhage当前10页，总共41页。 Thrombosisthrombosis is mostly venous not arterialmay result in bilateral deep venous thrombosis of the legspulmonary embolismvenous gangrene of fingers, toes, penis, or nipplesmyocardial infarction, strokemesenteric arterial thrombosislimb ischemia and amputationCirculation 1999;100:587-93Am J Med 1996;101:502-7Thromb Haemost 1993;70:554-61当前11页，总共41页。 Other Clinical FeaturesSkin lesions at heparin injection siteSkin necrosisA