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替罗非班所致急性严重血小板减少症的鉴别诊断与处理:一例报告

Differential diagnosis and management of acute profound thrombocytopenia by tirofiban: a case report.

作者信息

Demirkan Burcu, Guray Yesim, Guray Umit, Korkmaz Sule

机构信息

Yüksek Ihtisas Hospital, Cardiology Clinic, Ankara, Turkey.

出版信息

J Thromb Thrombolysis. 2006 Aug;22(1):77-8. doi: 10.1007/s11239-006-7789-1.

DOI:10.1007/s11239-006-7789-1
PMID:16786237
Abstract

Although the glycoprotein IIb/IIIa receptor inhibitors have improved outcomes of patients with acute coronary syndrome (ACS), therapy with these agents may cause thrombocytopenia with bleeding complications. This adverse effect is seemed to be rare with tirofiban. In this report, we describe a case of acute profound thrombocytopenia within two hours of tirofiban administration and review the differential diagnosis and the management of thrombocytopenia.

摘要

尽管糖蛋白IIb/IIIa受体抑制剂改善了急性冠状动脉综合征(ACS)患者的预后,但使用这些药物进行治疗可能会导致血小板减少并伴有出血并发症。替罗非班似乎很少出现这种不良反应。在本报告中,我们描述了1例在使用替罗非班后两小时内发生急性严重血小板减少的病例,并对血小板减少的鉴别诊断和管理进行了综述。

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Differential diagnosis and management of acute profound thrombocytopenia by tirofiban: a case report.替罗非班所致急性严重血小板减少症的鉴别诊断与处理:一例报告
J Thromb Thrombolysis. 2006 Aug;22(1):77-8. doi: 10.1007/s11239-006-7789-1.
2
[Acute profound thrombocytopenia associated with tirofiban: clinical approach to diagnosis and therapeutic management].[替罗非班相关的急性严重血小板减少症:诊断及治疗管理的临床方法]
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Practical approach to the diagnosis and management of thrombocytopenia associated with tirofiban treatment.替罗非班治疗相关血小板减少症的诊断与管理实用方法
Am J Hematol. 2004 Sep;77(1):67-71. doi: 10.1002/ajh.20149.
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Vanishing platelets: rapid and extreme tirofiban-induced thrombocytopenia after percutaneous coronary intervention for acute myocardial infarction.血小板消失:急性心肌梗死经皮冠状动脉介入治疗后替罗非班引起的快速且极度血小板减少症
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Acute thrombocytopenia after treatment with tirofiban or eptifibatide is associated with antibodies specific for ligand-occupied GPIIb/IIIa.使用替罗非班或依替巴肽治疗后出现的急性血小板减少症与针对配体占据的糖蛋白IIb/IIIa的特异性抗体有关。
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引用本文的文献

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Tirofiban-induced acute profound thrombocytopenia in endovascular therapy for acute ischemic stroke: a rare case report.替罗非班诱发急性缺血性脑卒中血管内治疗中急性严重血小板减少症:一例罕见病例报告
BMC Neurol. 2025 Aug 27;25(1):355. doi: 10.1186/s12883-025-04368-1.
2
Tirofiban-induced thrombocytopenia.替罗非班诱导的血小板减少症。
Ann Med. 2023 Dec;55(1):2233425. doi: 10.1080/07853890.2023.2233425.
3
A Simple Clinical Pre-procedure Risk Model for Predicting Thrombocytopenia Associated With Periprocedural Use of Tirofiban in Patients Undergoing Percutaneous Coronary Intervention.

本文引用的文献

1
Platelet-endothelial interactions: sepsis, HIT, and antiphospholipid syndrome.血小板-内皮细胞相互作用:脓毒症、肝素诱导的血小板减少症及抗磷脂综合征
Hematology Am Soc Hematol Educ Program. 2003:497-519. doi: 10.1182/asheducation-2003.1.497.
2
Intravenous glycoprotein IIb/IIIa receptor antagonists reduce mortality after percutaneous coronary interventions.静脉注射糖蛋白IIb/IIIa受体拮抗剂可降低经皮冠状动脉介入治疗后的死亡率。
J Am Coll Cardiol. 2003 Jan 1;41(1):26-32. doi: 10.1016/s0735-1097(02)02666-9.
3
Acute thrombocytopenia after treatment with tirofiban or eptifibatide is associated with antibodies specific for ligand-occupied GPIIb/IIIa.
一种用于预测接受经皮冠状动脉介入治疗的患者围手术期使用替罗非班相关血小板减少症的简单临床术前风险模型。
Front Pharmacol. 2018 Dec 10;9:1456. doi: 10.3389/fphar.2018.01456. eCollection 2018.
4
Severe thrombocytopenia and alveolar hemorrhage represent two types of bleeding tendency during tirofiban treatment: case report and literature review.严重血小板减少症和肺泡出血是替罗非班治疗期间的两种出血倾向类型:病例报告和文献复习。
Int J Hematol. 2012 Sep;96(3):370-5. doi: 10.1007/s12185-012-1133-7. Epub 2012 Jul 6.
5
Vanishing platelets: rapid and extreme tirofiban-induced thrombocytopenia after percutaneous coronary intervention for acute myocardial infarction.血小板消失:急性心肌梗死经皮冠状动脉介入治疗后替罗非班引起的快速且极度血小板减少症
Tex Heart Inst J. 2010;37(1):109-12.
使用替罗非班或依替巴肽治疗后出现的急性血小板减少症与针对配体占据的糖蛋白IIb/IIIa的特异性抗体有关。
Blood. 2002 Sep 15;100(6):2071-6.
4
Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: a meta-analysis of all major randomised clinical trials.急性冠状动脉综合征中血小板糖蛋白IIb/IIIa抑制剂:所有主要随机临床试验的荟萃分析
Lancet. 2002 Jan 19;359(9302):189-98. doi: 10.1016/S0140-6736(02)07442-1.
5
Temporal aspects of heparin-induced thrombocytopenia.肝素诱导的血小板减少症的时间因素。
N Engl J Med. 2001 Apr 26;344(17):1286-92. doi: 10.1056/NEJM200104263441704.
6
Images in cardiovascular medicine. Abciximab-associated pseudothrombocytopenia.心血管医学影像。阿昔单抗相关的假性血小板减少症。
Circulation. 2000 Feb 29;101(8):938-9. doi: 10.1161/01.cir.101.8.938.
7
A practical approach to the diagnosis and management of thrombocytopenia associated with glycoprotein IIb/IIIa receptor inhibitors.糖蛋白IIb/IIIa受体抑制剂相关性血小板减少症诊断与管理的实用方法
J Thromb Thrombolysis. 2000 Feb;9(2):175-80. doi: 10.1023/a:1018779116791.
8
Fibrinogen receptor antagonist-induced thrombocytopenia in chimpanzee and rhesus monkey associated with preexisting drug-dependent antibodies to platelet glycoprotein IIb/IIIa.
Blood. 1999 Jul 15;94(2):587-99.
9
A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina.阿司匹林联合替罗非班与阿司匹林联合肝素治疗不稳定型心绞痛的比较。
N Engl J Med. 1998 May 21;338(21):1498-505. doi: 10.1056/NEJM199805213382103.
10
Inhibition of the platelet glycoprotein IIb/IIIa receptor with tirofiban in unstable angina and non-Q-wave myocardial infarction.替罗非班抑制血小板糖蛋白IIb/IIIa受体在不稳定型心绞痛和非Q波心肌梗死中的应用
N Engl J Med. 1998 May 21;338(21):1488-97. doi: 10.1056/NEJM199805213382102.