Scharf R E
Institut für Experimentelle und Klinische Hämostaseologie, Hämotherapie und Transfusionsmedizin, Universitätsklinikum Düsseldorf, Biologisch-Medizinisches Forschungszentrum der Heinrich-Heine-Universität, Düsseldorf.
Hamostaseologie. 2008 Dec;28(5):299-311.
Given the high consumption of pharmacological agents in western societies, it is not surprising at all that drugs represent the most common cause of acquired platelet dysfunction. While acetylsalicylic acid, clopigogrel and integrin alphaIIbbeta3 (GPIIb-IIIa) receptor antagonists are well-known as prototypes of antiplatelet drugs, other widely used agents including non-steroidal anti-inflammatory drugs, antibiotics, serotonin reuptake inhibitors, and volume expanders can also impair platelet function and cause or aggravate haemorrhages. Besides pharmacological agents, certain clinical conditions are often associated with qualitative platelet disorders and bleeding diathesis. Consequently, in contrast to inherited platelet disorders, acquired platelet function defects are much more frequent in clinical practice and deserve special attention. Their pathogenesis is widespread and heterogeneous with various, sometimes overlapping abnormalities. Moreover, acquired platelet dysfunctions can occur at any age and range in severity from mild to life-threatening haemorrhages. Due to their heterogeneity, acquired platelet function disorders will be classified and discussed according to the underlying clinical setting or disease.
鉴于西方社会对药物制剂的高消费量，药物成为获得性血小板功能障碍最常见的原因也就不足为奇了。虽然乙酰水杨酸、氯吡格雷和整合素αIIbβ3（GPIIb-IIIa）受体拮抗剂作为抗血小板药物的原型广为人知，但其他广泛使用的药物，包括非甾体抗炎药、抗生素、5-羟色胺再摄取抑制剂和血容量扩充剂，也会损害血小板功能并导致或加重出血。除药物制剂外，某些临床病症常与血小板质量异常和出血素质相关。因此，与遗传性血小板疾病不同，获得性血小板功能缺陷在临床实践中更为常见，值得特别关注。其发病机制广泛且异质性强，存在各种有时相互重叠的异常情况。此外，获得性血小板功能障碍可发生于任何年龄，严重程度从轻到危及生命的出血不等。由于其异质性，将根据潜在的临床情况或疾病对获得性血小板功能障碍进行分类和讨论。
