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首页> 外文期刊>Revista Cubana de Hematología, Inmunología y Hemoterapia >Trombocitopenia inducida por f??rmacos
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Trombocitopenia inducida por f??rmacos

机译：药物性血小板减少症

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Thrombocytopenia can have several causes, including the use of certain drugs. The mechanism behind drug-induced thrombocytopenia is either a decrease in platelet production (bone marrow suppression) or an increased destruction (immune-mediated thrombocytopenia). In addition, pseudothrombocytopenia, an in vitro effect, has to be distinguished from true drug-induced thrombocytopenia. A small number of epidemiological studies, differing largely in the methodology used, describe incidences in the magnitude of 10 cases per 1 000 000 inhabitants per year. The underlying mechanism of drug-induced immune thrombocytopenia is not completely clarified, but at least six different types of antibodies appear to play a role; hapten-induced antibody, drug-dependent antibody ("compound" or "conformational-dependent" antibody), GPIIb-IIIa inhibitors, drug-induced autoantibody, immune complex and heparin-induced thrombocytopenia. Targets for drug-dependent antibodies are glycoproteins on the cell membrane of the platelets, such as glycoprotein (GP) Ib/IX and GPIIb/IIIa. Diagnosis of drug-induced immune thrombocytopenia may consist of identifying clinical symptoms (bruising, petechiae, bleeding), a careful evaluation of the causal relationship of the suspected causative drug, general laboratory investigation, such as total blood count and peripheral blood smear (to rule out pseudothrombocytopenia), and platelet serology tests. Although drug-induced thrombocytopenia is a relatively rare adverse drug reaction, its consequences may be severe.
机译：血小板减少症可能有多种原因，包括使用某些药物。药物诱导的血小板减少症的背后机制是血小板生成减少（骨髓抑制）或破坏增加（免疫介导的血小板减少症）。另外，必须将伪性血小板减少症（一种体外作用）与真正的药物诱导的血小板减少症区分开来。少数流行病学研究（所使用的方法差异很大）描述的发病率每年每10亿居民中有10例。药物诱导的免疫性血小板减少的潜在机制尚未完全阐明，但至少有六种不同类型的抗体似乎起作用。半抗原诱导的抗体，药物依赖性抗体（“化合物”或“构象依赖性”抗体），GPIIb-IIIa抑制剂，药物诱导的自身抗体，免疫复合物和肝素诱导的血小板减少症。药物依赖性抗体的靶标是血小板细胞膜上的糖蛋白，例如糖蛋白（GP）Ib / IX和GPIIb / IIIa。诊断药物引起的免疫性血小板减少症可能包括确定临床症状（瘀伤，瘀斑，出血），仔细评估可疑致病药物的因果关系，常规实验室检查，例如总血球计数和外周血涂片检查（假性血小板减少症）和血小板血清学检查。尽管药物诱发的血小板减少症是一种相对罕见的药物不良反应，但其后果可能很严重。

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