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肝素引起血小板减少已为周知,但明显的血小板减少由于血小板聚集有危及生命的血栓并发症罕见,未被广泛重视。患者66岁,男性,因急性前壁心肌梗塞而入冠心病监护室,给予利多卡因和肝素(5000_μ每12小时),普鲁卡因酰胺(500mg每4小时)治疗。心肌梗塞后第11天停用肝素,第13天患者述之左足趾痛,第15天左足疼加重左胫后动脉一过性消失,左足外侧及右小趾持续性
Heparin-induced thrombocytopenia is well-known, but the apparent thrombocytopenia is uncommon as a consequence of platelet aggregation with life-threatening thrombotic complications that have not been widely recognized. The patient, 66 years old, was admitted to the Coronary Care Unit with acute anterior myocardial infarction. Lidocaine and heparin (5000_μ every 12 hours) and procainamide (500 mg every 4 hours) were administered. Heparin was discontinued on day 11 post myocardial infarction, left toe pain was reported on day 13, left anterior descending artery disappeared on day 15, and the continuity of the left lateral and right little toe