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投稿时间：2022-03-17 网络发布日期：2022-10-20
投稿时间：2022-03-17 网络发布日期：2022-10-20
中文摘要: 目的 评估在下肢深静脉血栓治疗中应用阿加曲班抗凝对预防Ⅱ型肝素诱导的血小板减少症（HIT）的疗效。
方法 回顾性分析2018年5月至2019年6月于南京市第一医院治疗的下肢深静脉血栓患者285例的临床资料，根据治疗初始阶段使用的抗凝药物分为阿加曲班组（n=84）和低分子肝素组（n=201），比较两组患者Ⅱ型HIT的发病率，并通过二元logistic回归分析影响Ⅱ型HIT发病的危险因素。
结果 阿加曲班组Ⅱ型HIT发病率为1.2%（1/84），低分子肝素组为9.0%（18/201），差异有统计学意义(〖QX(Y10〗SymbolcA@〖QX)〗2=5.740,P=0.017)。二元logistic回归分析显示，低分子肝素抗凝相对于阿加曲班抗凝，是Ⅱ型HIT的独立危险因素(OR=7.963，95%CI：1.042~60.281，P=0.045)。
结论 低分子肝素抗凝相比于阿加曲班抗凝其Ⅱ型HIT发病率更高，是Ⅱ型HIT发生的独立危险因素。应用阿加曲班抗凝治疗下肢深静脉血栓，或可能预防Ⅱ型HIT的发生。
Abstract:ObjectiveTo evaluate the effect of argatroban anticoagulant therapy on the prevention of type Ⅱ heparin-induced thrombocytopenia(HIT) in the treatment of patients with lower extremity deep venous thrombosis(LEDVT).
Methods A retrospective analysis was performed on 285 LEDVT patients treated in Nanjing First Hospital from May 2018 to June 2019. According to the anticoagulant drugs used in the initial treatment, they were divided into argatroban group(n=84) and low-molecular-weight heparin(LMWH) group(n=201). The incidence of type Ⅱ HIT was compared between two groups and the risk factors of type Ⅱ HIT was analyzed by binary logistic regression.
Results The incidence of type Ⅱ HIT in argatroban group ［1.2%(1/84)］ was significantly lower than that ［9.0%(18/201)］ in LMWH group(〖QX(Y10〗SymbolcA@〖QX)〗2=5.740, P=0.017). Binary logistic regression analysis showed that LMWH anticoagulation relative to argatroban anticoagulation was an independent risk factor for type Ⅱ HIT (OR=7.963，95%〖KG-*8〗CI：1.042-60.281，P=0.045).
Conclusion Compared with argatroban anticoagulation, LMWH anticoagulation has a higher incidence of type Ⅱ HIT and is an independent risk factor for type Ⅱ HIT. In the treatment of LEDVT, argatroban may prevent the occurrence of type Ⅱ HIT.
文章编号： 中图分类号：R543.6 文献标志码：A
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引用文本：
孔杰,刘正立,赵伯翔,等.阿加曲班抗凝治疗下肢深静脉血栓对预防Ⅱ型肝素诱导的血小板减少症的疗效[J].中国临床研究,2022,35(10):1382-1385.
孔杰,刘正立,赵伯翔,等.阿加曲班抗凝治疗下肢深静脉血栓对预防Ⅱ型肝素诱导的血小板减少症的疗效[J].中国临床研究,2022,35(10):1382-1385.