摘要
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.
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on both upper extremities and the platelet count decreased to 5 × 109/L.Tirofiban,aspirin,and clopidogrel were withdrawn immediately and dexamethasone was given.On day 4 after PCI,clopidogrel was given again.On day 5 after PCI,aspirin was resumed.On day 6 after PCI,his ecchymoses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.
出处
《药物不良反应杂志》
CSCD
2013年第1期44-45,共2页
Adverse Drug Reactions Journal