阿伐曲泊帕致急性脑梗死及冠状动脉血栓形成一例  

Acute cerebral infarction and coronary thrombosis induced by avatrombopag:a case report

作　　者：李亚静 李丹[3,4] 林琦 廖紫琼 韩江莉 董淑杰[1,2] LI Yajing;LI Dan;LIN Qi;LIAO Ziqiong;HAN Jiangli;DONG Shujie(Department of Pharmacy,Peking University Third Hospital,Beijing 100191,China;Institute for Drug Evaluation,Peking University Health Science Center,Beijing 100191,China;Department of Cardiology,Beijing 100191,China;NHC Key Laboratory of Cardiovascular Molecular Bioloay and Requlatory Peptides,Peking University Beijing 100191,China)

机构地区：[1]北京大学第三医院药学部,北京100191 [2]北京大学医学部药物评价中心,北京100191 [3]北京大学第三医院心内科,北京100191 [4]国家卫生健康委心血管分子生物学与调节肽重点实验室,北京100191

出　　处：《临床药物治疗杂志》2024年第8期81-83,共3页Clinical Medication Journal

基　　金：国家自然科学基金(72304009)。

摘　　要：本文报道1例43岁男性因原发免疫性血小板减少症接受阿伐曲泊帕治疗导致急性脑梗死及冠状动脉血栓形成的案例。使用前患者血小板计数(PLT)30×10^(9)/L,首次使用阿伐曲泊帕5 d后发生急性脑梗死,PLT 107×10^(9)/L,暂停用药;后因患者PLT下降至30×10^(9)/L再次使用阿伐曲泊帕,5 d后因胸痛就诊,PLT 206×10^(9)/L,冠状动脉造影及光学相干断层扫描结果提示右冠状动脉中段血栓影,考虑很可能是阿伐曲泊帕引起的血小板增高导致冠状动脉血栓形成。药师及血液科专家会诊建议停用阿伐曲泊帕,给予阿司匹林、氯吡格雷抗血小板治疗。出院后根据PLT调整抗血小板聚集药物种类及剂量,随访患者未出现血栓事件。The article reported a case of a 43-year-old male who was treated with avatrombopag due to primary immune thrombocytopenia,resulting in acute cerebral infarction and coronary thrombosis.Before treatments,the platelet count(PLT)was 30×10^(9)/L.5 days later,the patient had acute cerebral infarction with the PLT 107×10^(9)/L.Since the PLT count decreased to 30×10^(9)/L afterwards,he was treated with avatrombopag again.5 days later,the patient had a chest pain,with the PLT count elevating to 206×10^(9)/L.Coronary angiography and optical coherence tomography suggested the presence of a thrombus in the mid-segment of the right coronary artery.The acute coronary syndrome was considered to be related to elevation of platelets caused by avatrombopag.After consultation with a clinical pharmacist and hematologist,the physicians were advised to stop avatrombopag,and start aspirin and clopidogrel for antiplatelet therapy.The antiplatelet medication was adjusted based on the PLT levels.During the follow-up,the patient did not experience any thrombosis events.

关 键 词：阿伐曲泊帕 血栓形成 原发免疫性血小板减少症 急性冠脉综合征 血小板 

分 类 号：R969.3[医药卫生—药理学] R972[医药卫生—药学]