Thrombocytopenia caused by treprostanil in treatment of idiopathic pulmonary aterial hypertension: a case report
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摘要: 28岁女性患者，以活动后气促、心悸为主要临床表现，完善血常规、肝肾功能、传染病标志物、风湿免疫、心脏超声、胸部CT、肺动脉CT、右心导管、肺功能等检查，确诊特发性肺动脉高压。曲前列尼尔治疗肺动脉高压引起血小板减少的报道较少，在治疗中应注意监测患者血小板计数，以防止出血发生。Abstract: A 28-year-old female patient, whose main clinical manifestations were dyspnea and palpitations after exercise, was diagnosed with idiopathic pulmonary arterial hypertension after blood routine, liver and kidney function, markers of infectious diseases, rheumatism immunity, cardiac ultrasound, chest CT, pulmonary artery CT, right cardiac catheterization, and pulmonary function. There are few reports of thrombocytopenia caused by treprostanil in the treatment of pulmonary arterial hypertension, we should pay attention to monitoring the change of platelet count to prevent bleeding.
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Key words:
- pulmonary arterial hypertension /
- prostacyclin /
- treprostanil /
- thrombocytopenia
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表 1 曲前列尼尔注射液使用剂量及相关指标变化情况
Table 1. Changes of treprostanil injection dosage and related indexes
使用时间 药物剂量/(ng· kg-1·min-1) 血小板计数/ (×109·L-1) 白细胞计数/ (×109·L-1) 红细胞计数/ (×1012·L-1) 血红蛋白计数/ (g·L-1) 血压/ mmHg 心率/ (次·min-1) 24 h尿量/ mL 第0天 0 114 11.35 5.77 171 97/63 89 1870 第1天 1.25 107 5.91 5.07 145 92/58 93 1700 第4天 5 54 5.35 5.07 146 92/60 98 1950 第5天 7.5 30 4.63 4.76 137 90/62 93 2500 第6天 10 36 5.61 4.6 134 90/61 97 1950 第8天 12.5 41 4.88 4.63 132 108/64 75 3650 第10天 7.5 70 4.94 4.55 131 99/60 68 1750 第12天 7.5 96 4.22 4.42 125 100/62 65 2000 第14天 7.5 101 4.95 4.53 131 104/62 75 1000 
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