目的 觀察阿加曲班對4例肝素致血小板減少癥的抗凝療效。方法 對臨床確診并以肝素進(jìn)行抗凝治療的202例靜脈血栓栓塞癥患者進(jìn)行臨床分析，定期監(jiān)測血常規(guī)及凝血指標(biāo)，以確定是否發(fā)生血小板減少癥的不良反應(yīng)。對其中4例肝素致血小板減少癥患者，停用肝素，給以阿加曲班治療，20 mg/d，治療3～7 d。結(jié)果 4例肝素致血小板減少癥患者換用阿加曲班后，血小板水平恢復(fù)至入院時水平，沒有發(fā)生血栓綜合征，同時患者下肢腫痛癥狀緩解速度快、療效好。結(jié)論 阿加曲班可替代肝素，有效預(yù)防肝素致血小板減少癥繼發(fā)的血栓綜合征。

Objective To observe the anticoagulation of Argatroban on 4 cases with heparin-induced thrombocytopenia (HIT). Methods A positive diagnosis for venous thromboembolism and anticoagulation contraindications in 202 cases was enrolled. All of them were treated with low molecular weight heparin (LMWH) and/or unfractionated heparin (UFH). The peripheral blood cells and coagulation indexes were examined regularly to determine if the adverse reaction of thrombocytopenia occured. Four cases of heparin-induced thrombocytopenia stopped using heparin, while was treated with Argatroban (20 mg/d) instead for 3－7 d. Results The platelet recovered to the basic level after withdrawing heparin and initiating Argatroban, the thrombotic syndrome did not appear and the lower limb swelling in clinical symptoms could be relieved immediately. Conclusion Argatroban could effectively replace heparin to prevent the secondary thrombosis with HIT.