关键词: 肝素, 肝素诱导的血小板减少症, 多学科诊疗, 4Ts评分, 抗PF₄-H抗体, 阿加曲班

Abstract:

Heparin-induced thrombocytopenia (HIT) is an antibody-mediated adverse reaction to heparin that is clinically manifested as a progressive reduction in platelet count after heparin administration, leading to venous and/or arterial thromboembolism and even death in severe cases. Acquired thrombocytopenia is commonly observed in hospitalized patients, the pathological mechanism is associated with drugs, autoimmune diseases, and consumptive thrombocytopenia. Patients with HIT frequently have complex clinical situations,and their manifestations are often atypical or mixed with other symptoms and signs, posing significant challenges to diagnosis and treatment for clinicians. Through the multidisciplinary diagnosis and treatment process of a HIT patient, this paper discusses HIT occurrence mechanism, clinical evaluation, laboratory testing and alternative anticoagulant therapy, so as to provide reference for doctors to accurately identify and effectively intervention in clinical practice.

Key words: heparin, heparin-induced thrombocytopenia, multi-disciplinary treatment, 4Ts score, anti-PF₄/H antibodies, argatroban