Hirsh Jack, Heddle Nancy, Kelton John G
Henderson Research Centre, Henderson Hospital, and the Department of Medicine, McMaster University, Hamilton, Ontario.
Arch Intern Med. 2004 Feb 23;164(4):361-9. doi: 10.1001/archinte.164.4.361.
Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin therapy that has a high rate of morbidity (thrombosis and amputation) and mortality. In the past, a number of different anticoagulants have been used to treat HIT in an attempt to prevent these complications. More recently, direct thrombin inhibitors have become popular. This systematic review summarizes the risk for thrombosis in HIT patients when heparin therapy is stopped; evidence of the efficacy of thrombin inhibitors in patients with HIT with and without thrombosis; evidence supporting the use of thrombin inhibitors in patients with a history of HIT who require a coronary intervention procedure; and the risk for bleeding when antithrombotic agents are used.
肝素诱导的血小板减少症（HIT）是肝素治疗的一种严重并发症，具有较高的发病率（血栓形成和截肢）和死亡率。过去，人们使用了多种不同的抗凝剂来治疗HIT，试图预防这些并发症。最近，直接凝血酶抑制剂变得流行起来。本系统综述总结了停用肝素治疗时HIT患者发生血栓形成的风险；凝血酶抑制剂在有或无血栓形成的HIT患者中的疗效证据；支持在有HIT病史且需要进行冠状动脉介入手术的患者中使用凝血酶抑制剂的证据；以及使用抗血栓药物时的出血风险。
