Division of Hematology, Puget Sound Blood Center, University of Washington, Seattle, WA 98104, USA.
Hematology Am Soc Hematol Educ Program. 2011;2011:391-6. doi: 10.1182/asheducation-2011.1.391.
Platelet dysfunction is commonly acquired due to medications, procedures, medical conditions, and underlying hematologic disease. These issues are presented, the data reviewed, and recommendations given herein. Many medications and dietary supplements have platelet-inhibitory effects in vitro, although the clinical effects on bleeding risks are unclear for many. Platelet-inhibitory drugs are key in the treatment of vascular disease. Data are available to aid in the management of these medications to prevent hemorrhagic complications. Bleeding in patients with renal failure has decreased with improved dialysis and the use of erythropoietin, but remains a challenge. Platelet dysfunction accompanies cardiac valvular disease and use of cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation. Hematologic disorders including myeloproliferative disorders (MPDs), myelodysplasia, paraproteinemias, and immune thrombocytopenia (ITP) can also be associated with hemorrhagic complications due to platelet dysfunction. Knowledge of which factors affect bleeding risk and how to treat individuals with acquired platelet dysfunction are important in optimizing patient care.
血小板功能障碍通常是由于药物、手术、医疗状况和潜在的血液疾病引起的。本文介绍了这些问题，回顾了相关数据，并提出了建议。许多药物和膳食补充剂在体外具有血小板抑制作用，但许多药物对出血风险的临床影响尚不清楚。血小板抑制剂在血管疾病的治疗中至关重要。有数据可用于管理这些药物，以预防出血并发症。随着透析和促红细胞生成素的使用，肾衰竭患者的出血情况有所减少，但仍然是一个挑战。血小板功能障碍伴随着心脏瓣膜疾病以及心肺旁路（CPB）和体外膜氧合的使用。血液系统疾病包括骨髓增生性疾病（MPD）、骨髓增生异常、副蛋白血症和免疫性血小板减少症（ITP），也可能由于血小板功能障碍而导致出血并发症。了解哪些因素会影响出血风险以及如何治疗获得性血小板功能障碍患者，对于优化患者护理非常重要。
