1例57岁男性患者因行溶栓术,给予尿激酶200 000 U,1次/6 h泵入;肝素钠12 500 U入0.9%氯化钠注射液50 ml进行24 h微量泵泵入。溶栓治疗当日血小板计数为126×109/L,第3天为99×109/L,第4天降至65×109/L。考虑为肝素诱导血小板减少症,停用肝素钠,改为阿加曲班抗凝,并继续应用尿激酶行第2次溶栓术。停用肝素钠后血小板计数即回升,第2、4天分别为93×109/L、113×109/L,第5天恢复到术前水平。 A 57-year-old male patient underwent thrombolytic therapy with 200 000 U of urokinase and 1/6 h pump. Heparin sodium 12 500 U was injected into 0.9% sodium chloride injection 50 ml for 24 h. Thrombolytic therapy day platelet count was 126 × 109 / L, the third day of 99 × 109 / L, the fourth day down to 65 × 109 / L. Consider heparin-induced thrombocytopenia, discontinue heparin sodium, change to argatroban anticoagulation, and continue urokinase for second thrombolysis. After stopping heparin sodium platelet count rebounded, the first two days were 93 × 109 / L, 113 × 109 / L, the first 5 days returned to preoperative level.