Гепарининдуцированная тромбоцитопения
https://doi.org/10.18087/cardio.2024.5.n2186
Аннотация
Широкое использование терапевтических доз гепарина для профилактики тромбозов у находящихся в критическом состоянии пациентов с COVID-19 во время пандемии привело к увеличению частоты развития кровотечений и гепарининдуцированной тромбоцитопении (ГИТ). Кроме того, внедрение в клиническую практику вакцины «AstraZeneca» и «Johnson&Johnson» против COVID-19 сопровождалось развитием редкого, но очень тяжелого нежелательного тромботического осложнения – вакциноиндуцированной иммунной тромботической тромбоцитопении (ВИТТ). Тромботические осложнения при ВИТТ оказались похожи на ГИТ как клинически, так и патофизиологически. ГИТ представляет собой потенциально смертельную иммуноопосредованную побочную лекарственную реакцию организма, в результате которой появляются антитела, активирующие тромбоциты в присутствии гепарина. Для ГИТ характерна высокая частота венозных и артериальных тромбозов, нередко с фатальными исходами. В настоящее время имеются четкие международные рекомендации по диагностике, лечению и профилактике ГИТ. В случае возникновения тромботических осложнений требуется применение негепариновых антикоагулянтов.
Ключевые слова
Об авторе
А. Б. СугралиевКазахстан
Кафедра внутренних болезней с курсом пропедевтики, зав кафедрой
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Рецензия
Для цитирования:
Сугралиев А.Б. Гепарининдуцированная тромбоцитопения. Кардиология. 2024;64(5):18-25. https://doi.org/10.18087/cardio.2024.5.n2186
For citation:
Sugraliyev A.B. Heparin-Induced Thrombocytopenia. Kardiologiia. 2024;64(5):18-25. (In Russ.) https://doi.org/10.18087/cardio.2024.5.n2186