心脏外科围术期肝素诱导血小板减少症的诊治进展  

Progress in diagnosis and treatment of heparin induced thrombocytopenia during perioperative period of cardiac surgery

作　　者：颜亚岚(综述) 温隽珉[2] 陈伟新(审校)[2] YAN Ya-lan;WEN Jun-min;CHEN Wei-xin(University of South China, Hengyang 421001, China;Department of Critical Care Medicine, Shenzhen Sun Yat-sen Cardiovascular Hospital, Shenzhen 518000, China)

机构地区：[1]南华大学,湖南省衡阳市421001 [2]深圳市孙逸仙心血管医院重症医学科

出　　处：《中国心血管病研究》2019年第4期311-315,共5页Chinese Journal of Cardiovascular Research

摘　　要：肝素诱导血小板减少症(HIT)是应用肝素后由抗体介导的不良反应,以血小板减少、伴或不伴血栓形成为主要临床表现.由于HIT发病率低、诊断结果时效长以及诊断技术要求高,大大降低了HIT的诊出率.治疗上非肝素抗凝剂种类繁多且适用阶段不同,临床上并无规范诊疗策略.部分研究已涉及新型口服抗凝剂(NOACs)、血浆置换及免疫抑制治疗,但未得到临床上广泛应用.心脏手术后HIT发病率较其他手术或内科疾病高,其围术期治疗也有特殊性.本文就近几年心脏手术围术期HIT的诊治进展进行综述,以期为临床医师提供参考.Heparin-induced thrombocytopenia (HIT) is an antibody-mediated adverse reaction after heparin administration. The main clinical manifestations are thrombocytopenia with or without thrombosis. Because of the low incidence of HIT. the long -terni of diagnosis results and high diagnostic technology requirements, is the diagnostic rate of HIT greatly reduced. There are various types of heparin anticoagulants and different stages of application. There is no standardized diagnosis and treatment strategy in clinic. Some studies have involved new oral anticoagulants ( NOACs), plasma exchange and immunosuppressive therapy. but which have not been widely used in clinic. The incidence of HIT after cardiac surgery is higher than that of other surgical or medical diseases especially in perioperative period. This article reviews the recent progress in the diagnosis and treatment of perioperative HIT in cardiac surgery in order to provide a reference for clinicians.

关 键 词：肝索诱导血小板减少症 抗血小板因子4/肝索复合物抗体 非肝素抗凝剂 

分 类 号：R654.2[医药卫生—外科学]