国人应用盐酸替罗非班致重度血小板减少的危险因素文献分析  

Analysis of characteristics and risk factors of acute serious thrombocytopenia associated with tirofiban in Chinese patients

作　　者：王静[1] 李汭傧[1] 崔炜[1] 

机构地区：[1]河北医科大学第二医院心内一科河北省心脑血管病研究所,河北石家庄050000

出　　处：《临床荟萃》2015年第4期361-366,共6页Clinical Focus

摘　　要：目的：探讨国人应用盐酸替罗非班致重度血小板减少的特点及危险因素。方法在中国知网、万方、维普、谷歌学术上检索2006年1月1日至2014年12月31日期间发表的盐酸替罗非班致重度血小板减少的相关文章,详细阅读入选文献,计算盐酸替罗非班致血小板减少的发生率,开始发现血小板减少、血小板减少至最低值、血小板恢复正常的中位时间以及替罗非班致血小板减少患者的性别比例。结果根据入选标准选出相关个案报道29篇（病例32个）,病例分析7篇。对7篇病例分析进行 Meta 分析得出盐酸替罗非班致国人重度血小板减少发生率为0.8%（95% CI =0.4%～1.2%）。在32例个案病例中,最早开始发现血小板减少的中位时间为12小时（6,24小时）；血小板减少至最低值的中位时间为13.5小时（6,24小时）；血小板恢复至正常范围（＞100×109/L）的中位时间为96小时（96,144小时）。所有应用盐酸替罗非班致重度血小板减少的患者（性别明确患者）共53例,其中男性占83.0%（44/53）。结论男性可能是国人应用盐酸替罗非班导致重度血小板减少的危险因素之一。Objective To investigate the characteristics and risk factors of acute serious thrombocytopenia associated with tirofiban in Chinese patients.Methods CNKI, Wanfang Data,VIP and Google Scholar were performed for the articles about tirofiban-induced acute serious thrombocytopenia between 2006-1-1and 2014-12-31.After detailed analysis of these literatures,incidence,time trend,and sex ratio of the patients with acute serious thrombocytopenia were analyzed.Results Twenty-nine case reports（thirty-two cases）and seven case analyses were collected.By Meta-analysis of the seven case analyses,the incidence of acute serious thrombocytopenia was 0.8%（95%CI =0.4%-1.2%）.By analyzing the twenty-nine case reports,the median time to onset of thrombocytopenia was 12h（6h,24h）after tirofiban treatment,and it usually takes a median time of 96h（96h,144h）to normal range for the platelets.Thrombocytopenia occurred more common in male patients（83.0%,44/53,）.Conclusion Male may be considered as one of the risk factors in Chinese patients with tirofiban-induced acute serious thrombocytopenia.

关 键 词：血小板减少 盐酸替罗非班 

分 类 号：R558.2[医药卫生—血液循环系统疾病]