Division of Vascular and Endovascular Surgery of the General Surgical Services, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
J Vasc Surg. 2012 Feb;55(2):562-70. doi: 10.1016/j.jvs.2011.10.082. Epub 2011 Dec 20.
Heparin-induced thrombocytopenia (HIT) is a serious, acquired, prothrombotic disorder caused by an antibody response to the heparin-platelet factor 4 complex, which can precipitate arterial as well as venous thromboembolic complications. HIT should be suspected in patients exposed to heparin who present with an unexplained thrombosis or a significant drop in platelet count, or both. Once HIT is suspected or identified, there are specific approaches to its diagnosis and management, with emphasis on removal of all heparin compounds and administration of alternative nonheparin anticoagulants. Generally, HIT is a self-limiting syndrome that resolves when the antibody titers disappear. Patients should be anticoagulated for up to 6 months, depending on the clinical scenario; however, the management of patients with remote or recent HIT requiring a vascular procedure requires special considerations.
肝素诱导的血小板减少症（HIT）是一种严重的获得性、促血栓形成性疾病，由针对肝素-血小板因子 4 复合物的抗体反应引起，可导致动脉和静脉血栓栓塞并发症。在接触肝素的患者中，出现不明原因的血栓形成或血小板计数显著下降，或两者兼有，应怀疑 HIT。一旦怀疑或确定 HIT，就需要采用特定的方法来诊断和管理，重点是去除所有肝素化合物并给予替代的非肝素抗凝剂。一般来说，当抗体效价消失时，HIT 是一种自限性综合征。根据临床情况，患者应接受抗凝治疗长达 6 个月；然而，对于需要血管介入治疗的 HIT 患者，尤其是那些发生在近期或远程的 HIT 患者，需要特殊的考虑。
