亚急性支架内血栓形成后再次应用盐酸替罗非班致极重度血小板减少一例报道  

Very Severe Thrombocytopenia Induced by Tirofiban Application Again after Subacute Stent Thrombosis:One Case Report

作　　者：刘艳军[1] 李海涛[1] 刁增利[1] 闫杰[1] 王志军[1] 葛庆锋[1] 刘培光[1] 

机构地区：[1]河北联合大学附属医院心内科,河北省唐山市063000

出　　处：《中国全科医学》2014年第15期1784-1786,共3页Chinese General Practice

摘　　要：急性冠脉综合征(ACS)是心内科最常见的急危重症之一,经皮冠状动脉介入术(PCI)是其重要的治疗手段。PCI前后抗血小板聚集药物的应用非常重要,然而血小板膜糖蛋白(GP)Ⅱb/Ⅲa受体拮抗剂(如盐酸替罗非班)诱导的血小板减少症的发生率明显升高。本文重点介绍1例PCI患者术后首次应用盐酸替罗非班未见血小板减少,但因患者亚急性支架内血栓形成后行PCI再次应用盐酸替罗非班导致极重度血小板减少。通过分析本例患者的临床资料及国外文献提示临床应用盐酸替罗非班时要严密监测血小板。Acute coronary syndrome（ACS） is one of the most common cardiology intensive diseases.The percutaneous coronary intervention（PCI）,especially the emergency or elective PCI is an important treatment.The application of anti- platelet aggregation drugs before and after the treatment is very important,but the incidence of thrombocytopenia（GIT） induced by platelet glycoprotein Ⅱb / Ⅲa receptor antagonist（for instance,tirofiban） can increase significantly.This article reports a case of PCI patients had no thrombocytopenia after the first application of tirofiban,but the tirofiban lead to severe thrombocytopenia after the application of tirofiban again after the second PCI because of subacute stent thrombosis.The study of this case and other literatures from other countries indicate that close attention should be paid to tirofiban- induced thrombocytopenia.

关 键 词：血栓形成 盐酸替罗非班 血小板减少 血小板膜糖蛋白类 经皮冠状动脉介入术 

分 类 号：R558.2[医药卫生—血液循环系统疾病]