任翠玲;富奇志;石见;

• 1:河南科技大学临床医学院河南科技大学第一附属医院

摘要(Abstract)：

替罗非班是一种可逆性非肽类血小板糖蛋白(GP)Ⅱb/Ⅲa受体拮抗剂,因具有t1/2短、起效快、过程可逆且安全性高等优势而广泛用于抑制血小板形成。既往研究表明,替罗非班治疗急性缺血性脑卒中安全、有效,而本文报道了1例应用替罗非班1 h后出现极重度血小板减少的急性缺血性脑卒中患者,旨在提高临床医生对替罗非班所致血小板减少的认识。

关键词(KeyWords)： 卒中;脑缺血;替罗非班;血小板减少;病例报告

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 任翠玲;富奇志;石见;

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参考文献(References)：

• [1]MERLINI A,ROSSI M,MENOZZI A,et al.Thrombocytopenia caused by abciximab or tirofiban and its association with clinical outcome in patients undergoing coronary stenting[J].Circulation,2004,109(18):2203-2206.DOI:10.1161/01.CIR.0000127867.41621.85.
• [2]SAID S M,HAHN J,SCHLEYER E,et al.GlycoproteinⅡb/Ⅲa inhibitor-induced thrombocytopenia[J].Chin Res Cardiol,2007,96(2):61-69.DOI:10.1007/s00392-006-0459-7.
• [3]MULOT A,MOULIN F,FOHLEN-WALTER A,et al.Practical approach to the diagnosis and management of thrombocytopenia associated with tirofiban treatment[J].Am J Hematol,2004,77(1):67-71.DOI:10.1002/ajh.20149.
• [4]SAKELLARIOU D,PASTROMAS S,KOULOURIS S,et al.First report of tirofiban-induced anemia(found in combination with severe thrombocytopenia)[J].Tex Heart Inst J,2009,36(1):55-57.
• [5]ELCIOGLU O C,OZKOK A,AKPINAR T S,et al.Severe thrombocytopenia and alveolar hemorrhage represent two types of bleeding tendency during tirofiban treatment:case report and literature review[J].Int J Hematol,2012,96(3):370-375.DOI:10.1007/s12185-012-1133-7.
• [6]DUNKLEY S,EVANS S,GAUDRY L,et al.Two distinct subgroups of tirofiban-induced thrombocytopenia exist due to drug dependent antibodies that cause platelet activation and increased ischaemic events[J].Platelets,2005,16(8):462-468. DOI:10.1080/09537100500140141.
• [7]ASTER R H.Immune thrombocytopenia caused by glycoproteinⅡb/Ⅲa inhibitors[J].Chest,2005,127(2 Suppl):53S-59S.DOI:10.1378/chest.127.2_suppl.53S.
• [8]SAID S M,HAHN J,SCHLEYER E,et al.GlycoproteinⅡb/Ⅲa inhibitor-induced thrombocytopenia:diagnosis and treatment[J].Clin Res Cardiol,2007,96(2):61-69.DOI:10.1007/s00392-006-0459-7.
• [9]PATEL S,PATEL M,DIN I,et al.Profound thrombocytopenia associated with tirofiban:case report and review of literature[J]. A n g i o l o g y, 2 0 0 5, 5 6(3):3 5 1-3 5 5. D O I:10.1177/000331970505600319.
• [10]MCCLURE M W,BERKOWITZ S D,SPARAPANI R,et al.Cli-nical significance of thrombocytopenia during a non-ST-elevation acute coronary syndrome. The platelet glycoproteinⅡb/Ⅲa in unstable angina:receptor suppression using integrilin therapy(PURSUIT)trial experience[J].Circulation,1999,99(22):2892-2900.DOI:10.1161/01.cir.99.22.2892.
• [11]YI Y H,YIN W J,GU Z C,et al.A simple clinical pre-procedure risk model for predicting thrombocytopenia associated with periprocedural use of tirofiban in patients undergoing percutaneous coronary intervention[J].Front Pharmacol,2018,9:1456.DOI:10.3389/fphar.2018.01456.
• [12]TORGANO G,ZECCA B,MONZANI V,et al.Effect of intravenous tirofiban and aspirin in reducing short-term and long-term neurologic deficit in patients with ischemic stroke:a double-blind randomized trial[J].Cerebrovasc Dis,2010,29(3):275-281.DOI:10.1159/000275503.
• [13]SIEBLER M,HENNERICI M G,SCHNEIDER D,et al.Safety of Tirofiban in acute Ischemic Stroke[J].Stroke,2011,42(9):2388-2392.DOI:10.1161/strokeaha.110.599662.
• [14]LIU J,SHI Q,SUN Y,et al.Efficacy of tirofiban administered at different time points after intravenous thrombolytic therapy with alteplase in patients with acute ischemic stroke[J].J Stroke Cerebrovasc Dis,2019,28(4):1126-1132.DOI:10.1016/j.jstrokecerebrovasdis.2018.12.044.
• [15]GEORGE J N,ASTER R H.Drug-induced thrombocytopenia:pathogenesis,evaluation,and management[J]. Hematology Am Soc Hematol Educ Program,2009:153-158.DOI:10.1182/asheducation-2009.1.153.
• [16]SANE D C,DAMARAJU L V,TOPOL E J,et al.Occurrence and clinical significance of pseudothrombocytopenia during abciximab therapy[J].J Am Coll Cardiol,2000,36(1):75-83.DOI:10.1016/s0735-1097(00)00688-4.
• [17]范小飞,张春燕.52例替罗非班致血小板减少症的文献分析[J].中国医院用药评价与分析,2018,18(2):259-260,263.DOI:10.14009/j.issn.1672-2124.2018.02.036.
• [18]VELIBEY Y,GOLCUK Y,EKMEKCI A,et al.Tirofiban-induced acute profound thrombocytopenia:what is the optimal approach to treatment?[J].Platelets,2015,26(2):197-198.DOI:10.3109/09537104.2013.787406.
• [19]HAMM C W,BASSAND J P,AGEWALL S,et al.ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation:The Task Force for the management of acute coronary syndromes(ACS)in patients presenting without persistent ST-segment elevation of the European Society of Cardiology(ESC)[J].Eur Heart J,2011,32(23):2999-3054.DOI:10.1093/eurheartj/ehr236.

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