1例55岁男性患者,因消化道出血入院治疗;第6日,饮食不慎后出现上腹部胀痛不适,加用雷贝拉唑钠肠溶胶囊、铝碳酸镁片;第7日,血小板计数(PLT)为420.00×109/L,幽门螺杆菌(+),予以含雷贝拉唑钠肠溶胶囊的四联疗法根除幽门螺杆菌治疗;第9日,PLT为523.00×109/L,后持续升高,最高达680.00×109/L;第21日,停用雷贝拉唑钠肠溶胶囊,改用口服雷尼替丁并停用四联疗法;第25日,PLT降至534.00×109/L,予以出院;出院后复查,PLT为372.00×109/L.该患者PLT升高由雷贝拉唑所致的可能性较大,相关机制有待进一步阐明.临床上若遇患者不明原因PLT升高,应考虑由雷贝拉唑引起的可能性,及时停药并做相应处理%A 55-year-old male patient was admitted to hospital for alimentary tract hemorrhage; at the 6 th day, the patient developed abdominal pain and discomfort due to inadvertent diet, which was given Rabeprazole sodium enteric-coated capsules combined with Hydrotalcite tablets; at the 7 th day, the platelet count (PLT) was 420.00×109/L, Helicobacter pylori was positive (+), which was given four-drug combination of Rabeprazole sodium enteric-coated capsules for eradicating H. pylori; at the 9 th day, the PLT was 523.00×109/L, with continuing rising, up to 680.00×109/L; at the 21 st day, the four-drug combination was discontinued, and Rabeprazole sodium enteric-coated capsules was replaced by oral ranitidine; at the 25 th day, the PLT decreased to 534.00×109/L and the patient was discharged from hospital; in the reexamination after discharge, the PLT was 372.00×109/L. It was considered the PLT rising was more likely induced by rabeprazole, relevant mechanism needed further elucidation. It was suggested when facing PLT rising for unknown reasons, the possibility of rabeprazole should be considered, the drug should be discontinued and treated accordingly.
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