中国药物警戒 ›› 2024, Vol. 21 ›› Issue (7): 829-835.
DOI: 10.19803/j.1672-8629.20240054

• 综述 • 上一篇    下一篇

药源性血小板减少症的发生机制及诊断

聂晓璐1,2,3, 马静瑶4, 孙凤2,3#, 詹思延2,*   

  1. 1国家儿童医学中心,首都医科大学附属北京儿童医院临床流行病与循证医学中心,北京 100045;
    2北京大学公共卫生学院流行病与卫生统计学系,北京 100091;
    3海南省真实世界数据研究院,海南 琼海 571437;
    4国家儿童医学中心,首都医科大学附属北京儿童医院血液病中心血液二科,北京 100045
  • 收稿日期:2024-01-25 出版日期:2024-07-15 发布日期:2024-07-31
  • 通讯作者: * 詹思延,女,博士,教授,循证医学与药物流行病学。E-mail：siyan-zhan@bjmu.edu.cn;#为共同通信作者。
  • 作者简介:聂晓璐,女,博士,副研究员,药物流行病学与循证医学。
  • 基金资助:
    国家自然科学基金资助项目(82204149); 北京市医院管理中心“青苗”计划专项经费资助（QML20231204); 北京儿童医院科研苗圃计划（3-1-014-01-04）; 海南博鳌乐城国际医疗旅游先行区真实世界研究专项计划项目(HNLC2022RWS012、HNLC2022RWS015)

Pathogenesis and diagnosis of drug-induced thrombocytopenia

NIE Xiaolu1,2,3, MA Jingyao4, SUN Feng2,3#, ZHAN Siyan2,*   

  1. 1Center for Clinical Epidemiology & Evidence-based Medicine, Beijing Children‘s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China;
    2Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100091, China;
    3Hainan Institute of Real World Data, Qionghai Hainan 571437, China;
    4Department II of Hematology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China;
  • Received:2024-01-25 Online:2024-07-15 Published:2024-07-31

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摘要： 药源性血小板减少症（drug-induced thrombocytopenia, DITP）是临床最常见的一种继发性血小板减少症。根据血小板减少症的发病机制可分为2大类：非免疫介导和药源性免疫性血小板减少症（drug-induced immune

关键词: 药源性血小板减少症, 免疫性, 半抗原, 药物依赖性, 肝素, 疫苗, 诱导, 药品不良反应

Abstract: Drug-Induced Thrombocytopenia (DITP) is the most common secondary thrombocytopenia in clinical practice. Based on the pathogenic mechanism, thrombocytopenia can be divided into two major categories: non-immune-mediated and drug-induced immune thrombocytopenia (DIIT). The latter is again classified into four categories based on different immune-mediated mechanisms. In addition to the classical pathway of drug-induced immune thrombocytopenia caused by drug-dependent platelet-reactive antibodies (DDAbs) binding to platelets, other categories include heparin-induced thrombocytopenia (HIT) and immune checkpoint inhibitors-induced thrombocytopenia(ICI-ITP). With the intensified development of vaccines and mass vaccinations following the global COVID-19 pandemic, a newly emerged category within DITP is vaccine-induced thrombotic thrombocytopenia (VITT). This article, in conjunction with related literature published in recent years, reviews the pathogenic characteristics and diagnosis of the aforementioned types of DITP, sorts out databases related to DITP and predicts the prospects of research.

Key words: drug-induced thrombocytopenia(DITP), immune, drug-dependent, antibodies, heparin, vaccine, induced, adverse drug reactions

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