Schwartz K A, Royer G, Kaufman D B, Penner J A
Am J Hematol. 1985 Aug;19(4):355-63. doi: 10.1002/ajh.2830190406.
The incidence, severity, and pathogenic mechanism of heparin-associated thrombocytopenia with both bovine and porcine heparin administration were studied in forty normal males randomized to one of four treatment groups: beef lung heparin #1, beef lung heparin #2, porcine gut heparin, and saline control. All of the subjects receiving heparin developed a reversible increase in serum transaminases (SGOT, SGPT). However, other measurements of liver function were normal. Thirty-three percent of these heparinized normals had decreased platelet counts. The incidence of platelet count decrease was similar for both bovine and porcine heparins, but 4 of the 20 normals receiving bovine heparin had platelet counts less than 150,000/microliters. Immune pathogenesis was investigated by analyzing plasma from the volunteers for both platelet antibody and immune complexes. None of the men had increased platelet-associated IgG. Among the ten subjects with decreased platelet counts, IgG immune complexes were detected in three and C1q in seven. The heparin-associated thrombocytopenia appears not to be mediated by a platelet antibody. More probably it reflects a direct effect of the heparin on platelets.
在四十名随机分为四个治疗组之一的正常男性中，研究了给予牛和猪肝素后肝素相关性血小板减少症的发生率、严重程度和发病机制：牛肺肝素#1、牛肺肝素#2、猪肠肝素和生理盐水对照。所有接受肝素治疗的受试者血清转氨酶（SGOT、SGPT）均出现可逆性升高。然而，其他肝功能指标正常。这些接受肝素治疗的正常人中有33%的血小板计数下降。牛肝素和猪肝素导致血小板计数下降的发生率相似，但在接受牛肝素治疗的20名正常人中，有4人的血小板计数低于150,000/微升。通过分析志愿者血浆中的血小板抗体和免疫复合物来研究免疫发病机制。所有男性的血小板相关IgG均未升高。在血小板计数下降的十名受试者中，三名检测到IgG免疫复合物，七名检测到C1q。肝素相关性血小板减少症似乎不是由血小板抗体介导的。更有可能的是，它反映了肝素对血小板的直接作用。
