Cosmi Benilde
a Department of Angiology & Blood Coagulation, S.Orsola-Malpighi University Hospital, Bologna, Italy.
Expert Rev Hematol. 2015 Dec;8(6):837-49. doi: 10.1586/17474086.2015.1087845. Epub 2015 Sep 14.
Heparin-induced thrombocytopenia (HIT) is an immune adverse reaction to heparin (both unfractionated and low-molecular-weight), which is mediated by the formation of IgG antibodies against platelet factor 4-heparin complexes. The IgG/platelet factor 4 immunocomplexes activate platelets with resulting thrombocytopenia, which is not associated with bleeding, but with paradoxical life-threatening thrombotic complications, for coagulation activation. HIT diagnosis requires the assessment of pre-test clinical probability in combination with the measurement of platelet activating antibodies against platelet factor 4-heparin complexes with immunological and functional assays. When HIT is diagnosed, any form of heparin should be stopped and a non-heparin alternative anticoagulant should be started. Argatroban and danaparoid are currently the only drugs licensed for HIT, with different country availability. Bivalirudin is an option in cardiac surgery and procedures in HIT patients.
肝素诱导的血小板减少症（HIT）是一种针对肝素（普通肝素和低分子肝素）的免疫不良反应，由针对血小板因子4 - 肝素复合物的IgG抗体形成介导。IgG/血小板因子4免疫复合物激活血小板，导致血小板减少，这与出血无关，而是与矛盾的危及生命的血栓并发症有关，用于凝血激活。HIT的诊断需要结合免疫和功能测定评估检测前临床概率以及测量针对血小板因子4 - 肝素复合物的血小板激活抗体。当诊断出HIT时，应停用任何形式的肝素，并开始使用非肝素替代抗凝剂。阿加曲班和达那肝素目前是仅有的获许可用于HIT的药物，在不同国家的可用性不同。比伐卢定是HIT患者心脏手术和操作中的一种选择。
