Department of Pediatrics, Stony Brook University School of Medicine, Pediatric Hematology/Oncology, Stony Brook Long Island Children's Hospital, Stony Brook, NY 11794-8111, USA.
Crit Care Clin. 2012 Jul;28(3):399-411, vi. doi: 10.1016/j.ccc.2012.04.007.
Thrombocytopenia is common in critically ill patients and increases morbidity and mortality. A diagnosis of heparin-induced thrombocytopenia (HIT) is frequently considered in any ICU patient who develops thrombocytopenia in the context of ongoing heparin exposure. As the usual tests to diagnose HIT are often neither specific nor sensitive enough to be confirmatory, the intensivist must largely rely on clinical judgment in treatment decisions. Patients in the ICU may also develop thrombocytopenia resulting from non-HIT immune mechanisms, nonimmune platelet consumption, and from decreased platelet production due to preexisting disorders or as a result of their critical illness and/or drug therapy.
血小板减少症在危重症患者中很常见，会增加发病率和死亡率。任何在持续肝素暴露的情况下发生血小板减少症的 ICU 患者，通常都会考虑肝素诱导的血小板减少症 (HIT) 的诊断。由于通常用于诊断 HIT 的检测既不特异也不敏感，因此重症医师在治疗决策中很大程度上必须依赖临床判断。ICU 中的患者也可能由于非 HIT 免疫机制、非免疫性血小板消耗以及由于先前存在的疾病或由于其危重病和/或药物治疗导致的血小板生成减少而发生血小板减少症。
