CAJ | 학술논문

1例56岁男性急性心肌梗死患者规律口服阿司匹林和氯吡格雷2个月后接受冠状动脉造影及经皮冠状动脉介入治疗.术前血小板计数为185×109/L.术中给予普通肝素,支架植入后用微量注射泵以0.1 μg/(kg·min)的速度持续静脉输注替罗非班36 h.输注替罗非班约12h,患者双上肢出现散在瘀斑,血小板计数下降至5×109/L.立即停用替罗非班、阿司匹林和氯吡格雷,并给予地塞米松.术后第4天,恢复使用氯吡格雷.术后第5天,恢复阿司匹林.术后第6天,患者瘀斑消失,血小板计数恢复至正常水平.考虑患者出现重度血小板减少是替罗非班所致.
1례56세남성급성심기경사환자규률구복아사필림화록필격뢰2개월후접수관상동맥조영급경피관상동맥개입치료.술전혈소판계수위185×109/L.술중급여보통간소,지가식입후용미량주사빙이0.1 μg/(kg·min)적속도지속정맥수주체라비반36 h.수주체라비반약12h,환자쌍상지출현산재어반,혈소판계수하강지5×109/L.립즉정용체라비반、아사필림화록필격뢰,병급여지새미송.술후제4천,회복사용록필격뢰.술후제5천,회복아사필림.술후제6천,환자어반소실,혈소판계수회복지정상수평.고필환자출현중도혈소판감소시체라비반소치.
A 56-year-old man with acute myocardial infarction underwent coronary arteriongraphy and percutaneous coronary intervention (PCI) after receiving regular treatment with oral aspirin and clopidogrel for 2 months.His platelet count was 185 × 109/L before PCI.Unfractionated heparin was given during the operation and an continuous Ⅳ infusion of tirofiban [0.1 μg/(kg · min)] was given for 36 hours via a micropump after PCI.About 12 hours after starting tirofiban,the patient presented with sporadic ecchymoses on both upper extremities and the platelet count decreased to 5 × 109/L.Tirofiban,aspirin,and clopidogrel were withdrawn immediately and dexamethasone was given.On day 4 after PCI,clopidogrel was given again.On day 5 after PCI,aspirin was resumed.On day 6 after PCI,his ecchymoses disappeared and the platelet count returned to normal level.The patient's severe thrombocytopenia was considered to be induced by tirofiban.