丁沙巴林后肝素诱导的血小板缺血:一个病例报告
Laila Khallaf1, Praveenkumar Katarki2, Nawaid Ahmad3
1Internal Medicine, Shrewsbury and Telford Hospital NHS Trust, Telford, GBR.
Cureus
|October 28, 2025
概括
氨酸诱导的血小板缺血 (HIT) 即使使用低分子量氨酸 (LMWH),也可以异常呈现. 及时诊断和切换抗凝剂对于患者的康复和预防并发症至关重要.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 氨酸诱导的血小板缺血 (HIT) 是一种严重的免疫反应,使氨酸治疗复杂化.
- 非典型的表现,如昏迷,以及由低分子量肝素 (LMWH) 诱导的HIT,带来了诊断挑战.
研究的目的:
- 报告在丁沙 (LMWH) 给药后出现昏迷的HIT病例.
- 强调早期识别和管理HIT的重要性,即使有不寻常的症状.
主要方法:
- 一个77岁的男性在EVAR后接受tinzaparin治疗的病例报告.
- 临床评估使用4Ts得分,实验室HIT抗体测试.
- 停止丁沙巴林治疗并启动 fondaparinux,随后进行华法林治疗.
主要成果:
- 患者在丁沙巴林后出现严重的血小板缺血和昏迷.
- 高度的临床怀疑 (4T得分6) 导致了及时干预.
- 血小板数恢复和成功的抗凝管理与 fondaparinux 和华法林.
结论:
- 在暴露于肝素后患有血小板缩症的患者中,无论呈现如何,都应该怀疑HIT.
- 早期诊断和转换为替代抗凝剂对于预防血栓栓塞事件至关重要.
- 像tinzaparin一样,LMWH可以诱导HIT,因此在临床实践中需要保持警.
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