Risch Lorenz, Huber Andreas R, Schmugge Markus
Clinical Decision Making Research Unit, Vorarlberg Institute of Vascular Investigation and Treatment (VIVIT), Academic Teaching Hospital, Feldkirch, Austria.
Thromb Res. 2006;118(1):123-35. doi: 10.1016/j.thromres.2004.12.020. Epub 2005 Feb 9.
Heparin-induced thrombocytopenia (HIT), a well-known side effect of heparin therapy, occurs with an incidence of 1-2% in certain pediatric patient groups. In affected children, HIT markedly increases the risk of venous and arterial thromboembolism. The use of alternative anticoagulation with danaparoid, lepirudin and argatroban in adults and children has demonstrated to be safe and could reduce morbidity and mortality also in affected pediatric patients. Thus, in children and neonates, an early diagnosis and accurate management is crucial to avoid the deleterious consequences of HIT. This review article will focus on the presentation of HIT in neonates and children. It reviews the pathophysiology of HIT and it summarizes epidemiological data. Finally important diagnostic and therapeutic issues are discussed.
肝素诱导的血小板减少症（HIT）是肝素治疗众所周知的副作用，在某些儿科患者群体中的发生率为1%-2%。在受影响的儿童中，HIT显著增加静脉和动脉血栓栓塞的风险。在成人和儿童中使用达那肝素、比伐卢定和阿加曲班等替代抗凝药物已证明是安全的，并且也可以降低受影响儿科患者的发病率和死亡率。因此，对于儿童和新生儿，早期诊断和准确管理对于避免HIT的有害后果至关重要。这篇综述文章将重点关注新生儿和儿童HIT的表现。它回顾了HIT的病理生理学并总结了流行病学数据。最后讨论了重要的诊断和治疗问题。
