Cipolle R J, Rodvold K A, Seifert R, Clarens R, Ramirez-Lassepas M
Ther Drug Monit. 1983 Jun;5(2):205-11.
Two hundred eleven consecutive patients treated for acute thromboembolic disease were evaluated prospectively for the incidence of thrombocytopenia while receiving heparin treatment. One hundred patients received beef lung heparin and 111 patients received porcine intestinal mucosal heparin. All patients received a minimum of 4 consecutive days of continuous intravenous heparin, and platelet counts were determined prior to, at least twice weekly, and at the cessation of heparin therapy. Heparin-associated thrombocytopenia was defined as a decline from a normal platelet count (100,000-400,000/mm3) to less than 100,000/mm3 with a return to above 100,000/mm3 after the discontinuation of heparin. Heparin-associated thrombocytopenia developed in 11 patients (5.2% incidence). Ten of the thrombocytopenic patients had received beef lung heparin and one received porcine mucosal heparin. Chi-square analysis of these data was significant (p = 0.007). Plasma from seven of nine thrombocytopenic patients demonstrated a plasma factor compatible with a heparin-sensitive antiplatelet antibody. Heparin-associated thrombocytopenia appeared on days 2 to 10 of therapy. Cessation of heparin resulted in remission of thrombocytopenia within 4 days in all patients. Serial quantitative platelet count determinations are indicated in all patients receiving therapeutic heparinization for the early recognition and resolution of heparin-associated thrombocytopenia.
对连续211例接受急性血栓栓塞性疾病治疗的患者在接受肝素治疗期间血小板减少症的发生率进行了前瞻性评估。100例患者接受牛肺肝素治疗，111例患者接受猪肠黏膜肝素治疗。所有患者至少连续4天接受持续静脉肝素治疗，在肝素治疗前、至少每周两次以及肝素治疗结束时测定血小板计数。肝素相关性血小板减少症定义为血小板计数从正常水平（100,000 - 400,000/mm³）降至低于100,000/mm³，且在停用肝素后恢复至100,000/mm³以上。11例患者（发生率5.2%）发生了肝素相关性血小板减少症。其中10例血小板减少症患者接受了牛肺肝素治疗，1例接受了猪黏膜肝素治疗。对这些数据进行卡方分析具有显著性（p = 0.007）。9例血小板减少症患者中有7例的血浆显示出与肝素敏感抗血小板抗体相容的血浆因子。肝素相关性血小板减少症出现在治疗的第2至10天。停用肝素后，所有患者的血小板减少症在4天内缓解。对于所有接受治疗性肝素化的患者，建议进行连续定量血小板计数测定，以便早期识别和解决肝素相关性血小板减少症。
