肝素诱导的血小板减少症的诊断和管理。
Diagnosis and management of heparin-induced thrombocytopenia.
机构信息
Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
出版信息
Hematol Oncol Clin North Am. 2013 Jun;27(3):541-63. doi: 10.1016/j.hoc.2013.02.001. Epub 2013 Apr 13.
Abstract
Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder caused by antibodies to platelet factor 4/heparin (PF4/H) complexes. It presents with declining platelet counts 5 to 14 days after heparin administration and results in a predisposition to arterial and venous thrombosis. Establishing the diagnosis of HIT can be extremely challenging. It is essential to conduct a thorough clinical evaluation in addition to laboratory testing to confirm the presence of PF4/H antibodies. Multiple clinical algorithms have been developed to aid the clinician in predicting the likelihood of HIT. Once HIT is recognized, an alternative anticoagulant should be initiated to prevent further complications.
摘要
肝素诱导的血小板减少症（HIT）是一种由抗血小板因子 4/肝素（PF4/H）复合物的抗体引起的血栓形成性疾病。它在肝素给药后 5 至 14 天出现血小板计数下降，并导致动脉和静脉血栓形成的易感性增加。确定 HIT 的诊断极具挑战性。除了实验室检测外，还必须进行彻底的临床评估以确认 PF4/H 抗体的存在。已经开发出多种临床算法来帮助临床医生预测 HIT 的可能性。一旦识别出 HIT，就应启动替代抗凝剂以防止进一步的并发症。
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