Yamamoto Haruko, Miyata Shigeki
Department of Advanced Medical Technology Development, Research and Development Initiative Center.
Rinsho Shinkeigaku. 2011 May;51(5):316-20. doi: 10.5692/clinicalneurol.51.316.
Immune-mediated heparin-induced thrombocytopenia (HIT) is a rare but serious side effect of heparin therapy which presents various thromboembolic events associated with high mortality and morbidity. There have been few reports about the prevalence of HIT in acute ischemic stroke, which our retrospective study and a multi-center prospective cohort study respectively estimated as 0.5% and 1.7% of unfractionated heparin-treated acute ischemic stroke patients. Once the onset of HIT is suspected, its therapy should be started immediately because treatment delay of HIT will bring a poor outcome. Stroke physicians should be aware of HIT, as heparin use will become increased more than ever in clinical practice with the development of new intravascular treatment techniques.
免疫介导的肝素诱导的血小板减少症(HIT)是肝素治疗中一种罕见但严重的副作用,会引发各种血栓栓塞事件,死亡率和发病率都很高。关于急性缺血性卒中中HIT的患病率,此前报道较少,我们的回顾性研究和一项多中心前瞻性队列研究分别估计,在接受普通肝素治疗的急性缺血性卒中患者中,HIT的患病率为0.5%和1.7%。一旦怀疑HIT发作,应立即开始治疗,因为HIT治疗延迟会导致不良后果。随着新的血管内治疗技术的发展,肝素在临床实践中的使用将会比以往任何时候都更多,卒中医生应该了解HIT。