临床荟萃 ›› 2025, Vol. 40 ›› Issue (7): 634-638.doi: 10.3969/j.issn.1004-583X.2025.07.008

• 论著 • 上一篇    下一篇

替罗非班导致迟发性极重度血小板减少2例并文献复习

钟元, 倪吉好, 孟风雷()   

  1. 北京市仁和医院 神经内科,北京 102600
  • 收稿日期:2025-06-30 出版日期:2025-07-20 发布日期:2025-07-17
  • 通讯作者: 孟风雷 E-mail:13810775741@163.com

Tirofiban-induced delayed, profound, severe thrombocytopenia: A report of two cases and literature review

Zhong Yuan, Ni Jihao, Meng Fenglei()   

  1. Department of Neurology, Beijing Renhe Hospital, Beijing 102600, China
  • Received:2025-06-30 Online:2025-07-20 Published:2025-07-17
  • Contact: Meng Fenglei E-mail:13810775741@163.com

摘要:

目的 探讨替罗非班导致迟发性极重度血小板减少的临床表现、发生机制及治疗。方法 报道替罗非班导致迟发性极重度血小板减少2例,并进行文献复习。结果 1例78岁男性患者在接受替罗非班治疗后第5天发生极重度血小板减少,血小板计数为1×109/L,患者于当日出现脑出血死亡;另1例85岁女性患者在接受替罗非班治疗后第5天出现极重度血小板减少,血小板计数最低为7×109/L,经激素治疗及血小板输注后第13天血小板恢复正常。结论 替罗非班所致迟发性极重度血小板减少非常罕见,其机制尚不明确,出血常是其表现出的唯一症状,多为轻微出血,严重出血极为罕见。治疗主要包括血小板输注、应用免疫球蛋白及激素。

关键词: 替罗非班, 血小板减少

Abstract:

Objective To explore the clinical manifestations, pathogenesis, and treatment of tirofiban-induced delayed, profound, severe thrombocytopenia. Methods Two cases of tirofiban-induced delayed, profound, severe thrombocytopenia were reported, and literature review was conducted. Results A 78-year old male patient experienced profound, severe thrombocytopenia on the 5th day of tirofiban, with a platelet count of 1×109/L. The patient died of cerebral hemorrhage on the same day. Another 85-year-old female patient experienced profound, severe thrombocytopenia on the 5th day after receiving treatment with tirofiban, with a minimum platelet count of 7×109/L. Platelets returned to normal on the 13th day after corticosteroids therapy and platelet transfusion. Conclusion Tirofiban-induced delayed, profound, severe thrombocytopenia is very rare, and its mechanism is still not clear. Bleeding may be the only symptom, and most of bleeding cases are mild. Severe bleeding caused by tirofiban is extremely rare. The treatment mainly includes platelet transfusion, intravenous immunoglobulin and corticosteroids.

Key words: tirofiban, thrombocytopenia

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