CAJ | 학술논문

目的：探讨盐酸替罗非班相关血小板减少症的发生率及相关影响因素,以便为临床合理安全用药提供参考。方法前瞻性分析就诊且住院期间应用盐酸替罗非班的急性冠状动脉综合征患者200例。观察纳入研究对象的人口学资料、血常规、血生化、盐酸替罗非班用法用量等,并在应用盐酸替罗非班24小时内复测血常规,以了解有无血小板减少症发生,并进一步分析影响因素。结果发生盐酸替罗非班相关血小板减少症者6例(3.0%),全部为男性,其中轻度血小板减少症3例(1.5%),重度血小板减少症1例(0.5%),极重度血小板减少症2例(1.0%)。血小板减少症开始发生的中位时间为8.5小时(2.0,16.0小时)。血小板减少组与未减少组吸烟、是否合并糖尿病、用药前血清肌红蛋白浓度及用药前基础血小板计数等4项指标差异有统计学意义(P <0.05)。进一步分析显示吸烟史、血清乳酸脱氢酶、左心室射血分数及冠状动脉造影史为盐酸替罗非班所致血小板减少症的独立影响因素。结论盐酸替罗非班所致血小板减少症在临床时有发生,需引起高度重视。在盐酸替罗非班应用过程中,特别是合并上述危险因素的男性患者,应注意动态监测血小板计数。
목적：탐토염산체라비반상관혈소판감소증적발생솔급상관영향인소,이편위림상합리안전용약제공삼고。방법전첨성분석취진차주원기간응용염산체라비반적급성관상동맥종합정환자200례。관찰납입연구대상적인구학자료、혈상규、혈생화、염산체라비반용법용량등,병재응용염산체라비반24소시내복측혈상규,이료해유무혈소판감소증발생,병진일보분석영향인소。결과발생염산체라비반상관혈소판감소증자6례(3.0%),전부위남성,기중경도혈소판감소증3례(1.5%),중도혈소판감소증1례(0.5%),겁중도혈소판감소증2례(1.0%)。혈소판감소증개시발생적중위시간위8.5소시(2.0,16.0소시)。혈소판감소조여미감소조흡연、시부합병당뇨병、용약전혈청기홍단백농도급용약전기출혈소판계수등4항지표차이유통계학의의(P <0.05)。진일보분석현시흡연사、혈청유산탈경매、좌심실사혈분수급관상동맥조영사위염산체라비반소치혈소판감소증적독립영향인소。결론염산체라비반소치혈소판감소증재림상시유발생,수인기고도중시。재염산체라비반응용과정중,특별시합병상술위험인소적남성환자,응주의동태감측혈소판계수。
Objective To observe incidence and risk factors of thrombocytopenia associated with tirofiban and to provide data for rational and safe use in clinical practice.Methods A prospetive study was performed in 200 acute coronary syndrome cases who were treated with tirofiban in the hospital. Demographic data, blood routine, biochemistry examination and usage and dosage of tirofiban were collected,and blood routine was re-examined within 24 h of tirofiban treatment.Results Tirofian-associated thrombocytopenia was identified in 6 cases(3.0%),all males, including 3 cases of mild thrombocytopenia, 1 case of severe thrombocytopenia and 2 cases of very severe thrombocytopenia.The median time to onset of thrombocytopenia was 8.5 h(2.0 h,1 6.0 h).There were significant differences in smoking,diabetes,myoglobin and platelet between thrombocytopenia and non-thrombocytopenia groups (P < 0.05 ).Further analysis indicated that smoking,lactate dehydrogenase,left venfricular ejection fraction and coronary angiography were considered as the independent risk factors of thrombocytopenia associated with tirofiban. Conclusion Tirofiban-associated thrombocytopenia requires close attention.Platelet should be monitored dynamically during treatment,especially for male patients with risk factors.