质子泵抑制剂致血小板减少症文献分析  

An analysis of the literature on thrombocytopenia induced by proton pump inhibitors

作　　者：闫阔 夏文斌[1] 杨慧鹃 杨啸白[1] 陆红柳[1] 李桃园[1] 张楠[1] YAN Kuo;XIA Wen-bin;YANG Hui-juan;YANG Xiao-bai;LU Hong-liu;LI Tao-yuan;ZHANG Nan(Department of Pharmacy,Beijing Chuiyangliu Hospital,Beijing 100022,China)

机构地区：[1]北京市垂杨柳医院药剂科,北京100022

出　　处：《临床药物治疗杂志》2022年第4期72-75,共4页Clinical Medication Journal

基　　金：首都临床特色应用研究项目(Z181100001718125);2019年北京药学会临床药学研究项目。

摘　　要：目的 探讨质子泵抑制剂(PPIs)致血小板减少症的特点,为临床合理用药提供参考。方法 检索国内外数据库截至2021年9月11日,收集质子泵抑制剂致血小板减少的病例报告类文献,记录患者性别、年龄、PPIs种类、应用PPIs前后血小板(PLT)数量变化等内容,进行描述性统计分析,同时对首次发现药源性血小板减少症(DITP)的血小板数量和停药前的血小板数量进行对比分析。结果 共计检索255篇文献,其中12篇文献纳入研究,共计13例患者,男女比例2.2:1,平均年龄(65.8±19.86)岁。涉及PPIs类药品4种,其中泮托拉唑占50.0%。临床表现,无症状为10例(76.9%),出血1例(7.7%),骨髓抑制1例(7.7%),伴白细胞下降1例(7.7%)。致DITP发生时间平均为(3.4±1.7)d。PLT数量在停药3 d内开始恢复,恢复至正常时间平均为(5.6±3.0)d。首次发现DITP时PLT数量和停药前的PLT数量,差异有统计学意义(P<0.05)。经停药及对症处理后所有病例均好转。结论 临床应用PPIs时应注意其血小板数量情况,及时监测血常规,以便早期识别DITP。Objective To investigate the characteristics of proton pump inhibitors(PPIs) induced thrombocytopenia,and provide reference for clinical rational drug use. Methods Domestic and foreign databases(up to September 11 th,2021) were searched to collect literature on case reports of thrombocytopenia caused by PPIs. Gender,age,PPIs’ type,platelet(PLT) counts before and after PPIs application,and other contents were recorded for descriptive statistical analysis. At the same time,the number of platelets when the drug-induced thromocytopeni(DITP) was detected for the first time and the number of platelets before drug withdrawal were compared and analyzed. Results A total of 255 literatures were retrieved,12 of which were included in the study,involving 13 patients with a 2. 2∶1 male to female ratio and a mean age of 65. 8±19. 86 years(35-98 years). Four kinds of PPIs were involved,among which pantoprazole accounted for 50. 0% of the cases. The clinical manifestations were asymptomatic in 10 cases(76. 9%),hemorrhage in 1 case(7. 7%),myelosuppression in 1 case(7. 7%),and leukopenia in 1 case(7. 7%). The average occurrence time of DITP was 3. 4±1. 7 days. PLT counts began to recover within 3 days of drug withdrawal,and the mean time to return to normal was 5. 6±3. 0 days. There was significant difference in PLT count between the first detection of DITP and that before drug withdrawal(P <0. 05). All cases improved after drug withdrawal and symptomatic treatment. Conclusion Attention should be paid to platelet count during the clinical application of proton pump inhibitors,and blood routine monitoring should be performed timely to identify DITP at an early stage.

关 键 词：质子泵抑制剂 血小板减少 药物不良反应 文献分析 

分 类 号：R973[医药卫生—药品]