Samoš Matej, Bolek Tomáš, Ivanková Jela, Stančiaková Lucia, Kovář František, Galajda Peter, Kubisz Peter, Staško Ján, Mokáň Marián
*Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic; †Division of Molecular Medicine, BioMed Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic; and ‡Department of Hematology and Blood Transfusion, Jessenius Faculty of Medicine in Martin, National Center of Hemostasis and Thrombosis, Comenius University in Bratislava, Martin, Slovak Republic.
J Cardiovasc Pharmacol. 2016 Nov;68(5):391-394. doi: 10.1097/FJC.0000000000000421.
Heparin-induced thrombocytopenia (HIT) is a life or limb-threatening thrombotic thrombocytopenia. HIT is traditionally treated with factor-IIa inhibitors such as bivalirudin, lepirudin, or argatroban. However, these agents usually require parenteral administration and are not generally available in all countries. Recently, several experiences with novel oral anticoagulants (NOACs) administration to treat HIT had been reported. NOACs generally offer advantages such as consistent and predictable anticoagulation, oral administration with good patient compliance, and a good safety profile. We report a case of HIT with severe thrombotic complications successfully treated with rivaroxaban and discuss the current knowledge about the use of NOACs for the treatment of this potentially fatal thrombocytopenia.
肝素诱导的血小板减少症（HIT）是一种危及生命或肢体的血栓性血小板减少症。传统上，HIT采用凝血因子IIa抑制剂进行治疗，如比伐卢定、重组水蛭素或阿加曲班。然而，这些药物通常需要胃肠外给药，且并非在所有国家都普遍可用。最近，已有几例关于使用新型口服抗凝剂（NOACs）治疗HIT的经验报道。NOACs通常具有一些优势，如抗凝作用持续且可预测、口服给药且患者依从性好，以及安全性良好。我们报告了一例使用利伐沙班成功治疗的伴有严重血栓并发症的HIT病例，并讨论了目前关于使用NOACs治疗这种潜在致命性血小板减少症的相关知识。
