Department of Haematology, University College London Hospital, Cardiometabolic Programme-NIHR UCLH/UCL BRC, London, UK.
Thrombosis and Anticoagulant Pharmacist, University College London Hospital, London, UK.
Br J Haematol. 2016 Jul;174(1):9-15. doi: 10.1111/bjh.14102. Epub 2016 Apr 21.
Heparin induced thrombocytopenia (HIT) remains a rare, but significant, condition related to mortality and morbidity. The incidence has decreased with reduced use of unfractionated heparin, with the exception of cardiac surgery. Due to the high risk of thrombosis, a switch to a non-heparin anticoagulant is required, until platelet counts normalize. Within the acute setting, argatroban, fondaparinux and direct acting oral anticoagulants (DOACS) are therapeutic options. In patients with HIT-associated thrombosis or who require long-term anticoagulation, warfarin remains the preference, but DOACs are attractive alternatives.
肝素诱导的血小板减少症（HIT）仍然是一种罕见但严重的与死亡率和发病率相关的疾病。由于非普通肝素的使用率降低，除了心脏手术外，这种发病率有所下降。由于血栓形成的风险很高，需要切换到非肝素抗凝剂，直到血小板计数恢复正常。在急性情况下，阿加曲班、磺达肝素钠和直接作用口服抗凝剂（DOAC）是治疗选择。对于 HIT 相关血栓形成或需要长期抗凝的患者，华法林仍然是首选，但 DOAC 是有吸引力的替代品。
