Opatrny Lucie, Warner Margaret N
Division of Internal Medicine, Department of Medicine, McGill University Health Center, Royal Victoria Hospital Room A4.21, 687 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1.
Am J Hematol. 2004 Jul;76(3):240-4. doi: 10.1002/ajh.20098.
Heparin-induced thrombocytopenia (HIT) is a common immunological drug reaction. After exposure to heparin, some patients develop heparin dependent antibodies with no evidence of thrombosis, while others are at risk of thrombocytopenia, thrombosis, limb loss, and death. We conducted a retrospective chart review on all patients serologically positive for HIT by HPIA ELISA in a single tertiary-care hospital, to determine whether patients with malignancy had an increased risk of thrombotic complications. Medical records of 55 patients who tested positive for HIT and met clinical criteria for HIT were analyzed. All patients had been treated with unfractionated heparin. Malignancy was diagnosed in 11 patients, either at surgery or post-mortem examination. A higher rate of venous thrombosis and pulmonary embolism was observed in patients with HIT and malignant disease when compared to patients with no underlying malignancy (odds ratio 13.6, 95% CI 2.9-63.8).
肝素诱导的血小板减少症（HIT）是一种常见的免疫性药物反应。接触肝素后，一些患者会产生肝素依赖性抗体，但无血栓形成证据，而另一些患者则有血小板减少、血栓形成、肢体丧失和死亡的风险。我们对一家三级医疗中心医院中所有通过HPIA ELISA血清学检测HIT呈阳性的患者进行了回顾性病历审查，以确定恶性肿瘤患者发生血栓并发症的风险是否增加。分析了55例HIT检测呈阳性且符合HIT临床标准患者的病历。所有患者均接受了普通肝素治疗。11例患者在手术或尸检时被诊断为恶性肿瘤。与无潜在恶性肿瘤的患者相比，HIT合并恶性疾病的患者静脉血栓形成和肺栓塞的发生率更高（优势比13.6，95%可信区间2.9-63.8）。
