肝素诱导性血小板减少症的研究进展

石茂静; 高伟波; 朱继红

doi:10.13201/j.issn.1009-5918.2018.09.004

肝素诱导性血小板减少症的研究进展

- 北京大学人民医院急诊科(北京, 100044)

详细信息

通讯作者: 高伟波,E-mail:13699185078@163.com

中图分类号: R554.6

收稿日期: 2018-07-25

The research progress of heparin induced thrombocytopenia

More Information

Corresponding author: , E-mail: 13699185078@163.com

Received Date: 25 July 2018

摘要

- 肝素诱导性血小板减少症 /
- 发病机制 /
- 治疗
Abstract: Heparin is ofen used in the prevention and treatment of thrombotic diseases, heparin induced thrombocytopenia is a serious side effect of heparin, this paper mainly introduces the pathogenesis, epidemiology, clinical manifestations, diagnosis and treatment methods.The nature of the disease is an immune response to heparin, characterized by a relative or absolute reduction of platelets associated with thrombosis.Treatment is mainly to discontinue heparin and take some alternative anticoagulant therapy.
- heparin induced thrombocytopenia /
- pathogenesis /
- treatment

HTML全文

参考文献(64)

[1]	Thong C L, Kam P C A.Heparin-induced thrombocytopenia[J].Curr Anaesth Crit Care, 2005, 16 (2):143-150.
[2]	Greinacher A, Warkentin T E.Recognition, treatment, and prevention of heparin-induced thrombocytopenia:review and update[J].Thromb Res, 2006, 118 (2):165-176.
[3]	Battistelli S, Genovese A, Gori T.Heparin-induced thrombocytopenia in surgical patients[J].Am J Surg, 2010, 199 (1):43-51.
[4]	Greinacher A.Heparin-induced thrombocytopenia[J].N Engl J Med, 2015, 373 (19):1883-1884.
[5]	Aster R H.Heparin-induced thrombocytopenia and thrombosis[J].N Engl J Med, 1995, 332 (15):1374-1376.
[6]	Shoenfeld Y, Praprotnik S, Levy Y, et al.Pathogenic anti-endothelial cell antibodies:classify cation to antimicrovascular EC and anti-macrovascular EC antibodies[J].Isr Med Assoc J, 2000, 2 (1):24-25.
[7]	Rollin J, Pouplard C, Gruel Y.Risk factors for heparininduced thrombocytopenia:Focus on Fcγreceptors[J].Thromb Haemost, 2016, 116 (5):799-805.
[8]	Khairy M, Lasne D, Amelot A, et al.Polymorphonuclear leukocyte and monocyte activation induced by plasma from patients with heparininduced thrombocytopenia in whole blood[J].Thromb Haemost, 2004, 92 (6):1411-1419.
[9]	Davidson S J, Wadham P, Rogers L, et al.Endothelial cell damage in heparin-induced thrombocytopenia[J].Blood Coagul Fibrinolysis, 2007, 18 (4):317-320.
[10]	Kelton J G, Warkentin T E.Heparininduced thrombocytopenia:a historical perspective[J].Blood, 2008, 112 (7):2607-2616.
[11]	Linkins L A, Dans A L, Moores L K, et al.Treatment and prevention of heparin-induced thrombocytopenia:Antithrombotic Therapy and Prevention of Thrombosis, 9th ed:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J].Chest, 2012, 141 (2):e495S-e530S.
[12]	Warkentin T E, Greinacher A, Koster A, et al.Treatment and prevention of heparin-induced thrombocytopenia:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition)[J].Chest, 2008, 133 (2):340S-380S.
[13]	Cuker A.Heparin-induced thrombocytopenia (HIT) in 2011:an epidemic of overdiagnosis[J].Thromb Haemost, 2011, 106 (8):993-994.
[14]	Cuker A.Heparin-induced thrombocytopenia:present and future[J].J Thromb Thrombolysis, 2011, 31 (4):353-366.
[15]	Warkentin T E, Sheppard J A, Horsewood P, et al.Impact of the patient population on the risk for heparininduced thrombocytopenia[J].Blood, 2000, 96 (6):1703-1708.
[16]	Arepally G M, Ortel T L.Clinical practice.Heparininduced thrombocytopenia[J].N Engl J Med, 2006, 355 (8):809-817.
[17]	Martel N, Lee J, Wells P S.Risk for heparin-induced thrombocytopenia with unfractionated and low-molecular-weight heparin thromboprophylaxis:a meta-analysis[J].Blood, 2005, 106 (7):2710-2715.
[18]	Warkentin T E, Kelton J G.Temporal aspects of heparin-induced thrombocytopenia[J].N Engl J Med, 2001, 344 (12):1286-1292.
[19]	Greinacher A, Eichler P, Lubenow N, et al.Heparininduced thrombocytopenia with thromboembolic complications:meta-analysis of 2prospective trials to assess the value of parenteral treatment with lepirudin and its therapeutic aPTT range[J].Blood, 2000, 96 (3):846-851.
[20]	Warkentin T E.Heparin-induced thrombocytopenia[J].Hematol Oncol Clin North Am, 2007, 21 (5):589-607.
[21]	Greinacher A, Farner B, Kroll H, et al.Clinical features of heparin-induced thrombocytopenia including risk factors for thrombosis.A retrospective analysis of 408 patients[J].Thromb Haemost, 2005, 94 (1):132-135.
[22]	中国医师协会心血管内科医师分会血栓防治专业委员会, 《中华医学杂志》编辑委员会.肝素诱导的血小板减少症中国专家共识 (2017)[J].中华医学杂志, 2018, 98 (6):408-417.
[23]	Selleng K, Warkentin T E, Greinacher A.Heparin-induced thrombocytopenia in intensive care patients[J].Crit Care Med, 2007, 35 (4):1165-1176.
[24]	Wester J P, Haas F J, Biesma D H, et al.Thrombosis and hemorrhage in heparin-induced thrombocytopenia in seriously ill patients[J].Intensive Care Med, 2004, 30 (10):1927-1934.
[25]	Warkentin T E.Heparin-induced thrombocytopenia[J].Dis Mon, 2005, 51 (2):141-149.
[26]	Shantsila E, Lip G Y, Chong BH.Heparin-induced thrombocytopenia.A contemporary clinical approach to diagnosis and management[J].Chest, 2009, 135 (8):1651-1664.
[27]	Joglekar M, Khandelwal S, Cines D B, et al.Heparin enhances uptake of platelet factor 4/heparin complexes by monocytes and macrophages[J].J Thromb Haemost, 2015, 13 (8):1416-1427.
[28]	Warkentin T E.Heparin-induced thrombocytopenia:pathogenesis and management[J].Br J Haematol, 2003, 121 (3):535-555.
[29]	Lo G K, Juhl D, Warkentin T E, et al.Evaluation of pretest clinical score (4T's) for the diagnosis of heparin-induced thrombocytopenia in two clinical settings[J].J Thromb Haemost, 2006, 4 (4):759-765.
[30]	Warkentin T E, Greinacher A.Heparin-induced thrombocytopenia:recognition, treatment, and prevention:the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy[J].Chest, 2004, 126 (3 Suppl):311S-337S.
[31]	Lubenow N, Eichler P, Lietz T, et al.Lepirudin in patients with heparin-induced thrombocytopenia-results of the third prospective study (HAT-3) and a combined analysis of HAT-1, HAT-2, and HAT-3[J].JThromb Haemost, 2005, 3 (3):2428-2436.
[32]	Tardy-Poncet B, Wolf M, Lasne D, et al.Danaparoid cross-reactivity with heparin-induced thrombocytopenia antibodies:report of 12cases[J].Intensive Care Med, 2009, 35 (8):1449-1453.
[33]	Szokol J W.Heparin-induced thrombocytopenia[J].Semin Cardiothorac Vasc Anesth, 2010, 14 (1):73-74.
[34]	Lobo B, Finch C, Howard A, et al.Fondaparinux for the treatment of patients with acute heparin-induced thrombocytopenia[J].Thromb Haemost, 2008, 99 (2):208-214.
[35]	Garcia D A, Baglin T P, Weitz J I, et al.Parenteral anticoagulants:Antithrombotic Therapy and Prevention of Thrombosis, 9th ed:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J].Chest, 2012, 141 (1):e24S-e43S.
[36]	Warkentin T E.Fondaparinux versus direct thrombin inhibitor therapy for the management of heparin-induced thrombocytopenia (HIT) -bridging the River Coumarin[J].Thromb Haemost, 2008, 99 (1):2-3.
[37]	Warkentin T E, Cook R J, Marder V J, et al.Antiplatelet factor 4/heparin antibodies in orthopedic surgery patients receiving antithrombotic prophylaxis with fondaparinux or enoxaparin[J].Blood, 2005, 106 (12):3791-3796.
[38]	Kang M, Alahmadi M, Sawh S, et al.Fondaparinux for the treatment of suspected heparin-induced thrombocytopenia:a propensity score-matched study[J].Blood, 2015, 125 (5):924-929.
[39]	Bhatt V R, Dahal S, Verma V, et al.Fondaparinux for management of heparininduced thrombocytopenia after cardiovascular intervention:a systematic review[J].Cardiovasc Hematol Agents Med Chem, 2015, 13 (1):82-86.
[40]	Lewis B E, Wallis D E, Berkowitz S D, et al.Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia[J].Circulation, 2001, 103 (4):1838-1843.
[41]	Lewis B E, Wallis D E, Leya F, et al.Argatroban anticoagulation in patients with heparin-induced thrombocytopenia[J].Arch Intern Med, 2003, 163 (4):1849-1856.
[42]	Keegan S P, Gallagher E M, Ernst N E, et al.Effects of critical illness and organ failure on therapeutic argatroban dosage requirements in patients with suspected or confirmed heparin-induced thrombocytopenia[J].Ann Pharmacother, 2009, 43 (1):19-27.
[43]	Warkentin T E.Agents for the treatment of heparininduced thrombocytopenia[J].Hematol Oncol Clin North Am, 2010, 24 (3):755-775.
[44]	Rice L.Heparin-induced thrombocytopenia:myths and misconceptions (that will cause trouble for you and your patient)[J].Arch Intern Med, 2004, 164 (18):1961-1964.
[45]	Warkentin T E, Greinacher A, Koster A.Bivalirudin[J].Thromb Haemost, 2008, 99 (5):830-839.
[46]	Al-Ali F S, Elsayed M, Khalifa S, et al.Successful use of a bivalirudin treatment protocol to prevent extracorporeal thrombosis in ambulatory hemodialysis patients with heparin-induced thrombocytopenia[J].Hemodial Int, 2015, 20 (1):204-207.
[47]	Koster A, Dyke C M, Aldea G, et al.Bivalirudin during cardiopulmonary bypass in patients with previous or acute heparin-induced thrombocytopenia and heparin antibodies:results of the CHOOSE-ON trial[J].Ann Thorac Surg, 2007, 83 (2):572-577.
[48]	Ng H J, Than H, Teo E C.First experiences with the use of rivaroxaban in the treatment of heparin-induced thrombocytopenia[J].Thromb Res, 2015, 135 (1):205-207.
[49]	Linkins L A, Warkentin T E.Rivaroxaban for treatment of HIT:a riveting first experience[J].Thromb Res, 2015, 135 (1):1-2.
[50]	Hantson P, Lambert C, Hermans C.Rivaroxaban for arterial thrombos is related to heparin-induced thrombocytopenia[J].Blood Coagul Fibrinolysis, 2015, 26 (1):205-206.
[51]	Abouchakra L, Khabbaz Z, Abousassi S, et al.Rivaroxaban for treatment of heparin-induced thrombocytopenia after cardiac surgery:a case report[J].J Thorac Cardiovasc Surg, 2015, 150 (1):e19-e20.
[52]	Sartori M, Favaretto E, Cini M, et al.Rivaroxaban in the treatment of heparininduced thrombocytopenia[J].J Thromb Thrombolysis, 2015, 40 (2):392-394.
[53]	Larsen P B, Jørgensen M, Friis-Hansen L, et al.Apixaban used for the management of heparin-induced thrombocytopenia in a 72-year-old woman with lung cancer[J].Clin Case Rep, 2015, 3 (3):987-989.
[54]	Linkins L A, Warkentin T E, Pai M, et al.Rivaroxaban for treatment of suspected or confirmed heparin-induced thrombocytopenia study[J].J Thromb Haemost, 2016, 14 (6):1206-1210.
[55]	Warkentin T E, Elavathil L J, Hayward C P, et al.The pathogenesis of venous limb gangrene associated with heparin-induced thrombocytopenia[J].Ann Intern Med, 1997, 127 (7):804-812.
[56]	Warkentin T E.Should vitamin K be administered when HIT is diagnosed after administration of coumarin?[J].J Thromb Haemost, 2006, 4 (4):894-896.
[57]	Lubenow N, Kempf R, Eichner A, et al.Heparininduced thrombocytopenia:temporal pattern of thrombocytopenia in relation to initial use or reexposure to heparin[J].Chest, 2002, 122 (1):37-42.
[58]	Warkentin T E, Kelton J G.Delayedonset heparin-induced thrombocytopenia and thrombosis[J].Ann Intern Med, 2001, 135 (7):502-506.
[59]	Rice L M, Attisha W K, Drexler A M, et al.Delayedonset heparin-induced thrombocytopenia[J].Ann Intern Med, 2002, 136 (1):210-215.
[60]	Theodore E W, Troy H C, Pierre A M.Intravenous Immune Globulin to Prevent Heparin-Induced Thrombocytopenia[J].N Engl J Med, 2018, 378 (18):1845-1848.
[61]	Warkentin T E, Sheppard J A.Serological investigation of patients with a previous history of heparin-induced thrombocytopenia who are reexposed to heparin[J].Blood, 2014, 123 (16):2485-2493.
[62]	Linkins L A, Dans A L, Moores L K, et al.Treatment and prevention of heparin induced thrombocytopenia:antithrombotic therapy and prevention of thrombosis, 9th ed:American College of Chest Physicians evidence-based clinical practice guidelines[J].Chest, 2012, 141 (3):e495S-e530S.
[63]	Warkentin T E, Sheppard J A, Chu F V, et al.Plasma exchange to remove HIT antibodies:dissociation between enzyme-immunoassay and platelet activation test reactivities[J].Blood, 2015, 125 (2):195-198.
[64]	John G K, Donald M A, Shannon M B.Nonheparin Anticoagulants for Heparin-Induced Thrombocytopenia[J].N Engl J Med, 2013, 368 (7):737-744.