盐酸替罗非班氯化钠注射液致血栓性血小板减少性紫癜1例分析

doi:10.19803/j.1672-8629.20250297

中国药物警戒 ›› 2026, Vol. 23 ›› Issue (3): 346-348.
DOI: 10.19803/j.1672-8629.20250297

盐酸替罗非班氯化钠注射液致血栓性血小板减少性紫癜1例分析

曹阳, 付晓秀, 马林^*

聊城市第二人民医院,山东第一医科大学附属聊城二院临床药学科,山东聊城 252600

收稿日期:2025-05-16 出版日期:2026-03-15 发布日期:2026-03-17
通讯作者: ^*马林,女,硕士,副主任药师,心血管内科临床药学。E-mail: malin198502@163.com
作者简介:曹阳,男,硕士,主管药师,神经内科临床药学。

One Case of Thrombotic Thrombocytopenic Purpura Caused by Tirofiban Hydrochloride and Sodium Chloride Injection

CAO Yang, FU Xiaoxiu, MA Lin^*

Department of Clinical Pharmacy, the Second People’s Hospital of Liaocheng, the Second Hospital of Liaocheng Affiliated to Shandong First Medical University, Liaocheng Shandong 252600, China

Received:2025-05-16 Online:2026-03-15 Published:2026-03-17

摘要/Abstract

摘要： 目的分析替罗非班致血栓性血小板减少性紫癜（TTP）病例,为临床安全用药提供参考。方法结合国内外文献,探讨1例替罗非班引起TTP的临床表现、发生机制及治疗策略。结果患者在应用替罗非班后第6天出现血小板计数严重减少、出血、肢体无力、反应迟钝及微血管病性溶血性贫血。结合骨髓穿刺结果,考虑可能为替罗非班引起TTP,血小板计数于停药并对症治疗后第9天恢复正常。结论替罗非班可引起TTP风险,临床应用期间应密切监测血小板计数,一旦怀疑TTP,须立即进行风险评估或检测血管性血友病因子裂解蛋白酶（ADAMTS13）活性,以尽早识别和处置。

关键词: 替罗非班, 血栓性血小板减少性紫癜, 微血管病性溶血性贫血, 药品不良反应

Abstract: Objective To investigate one case of tirofiban-induced thrombotic thrombocytopenic purpura (TTP) so as to provide a reference for safe medication. Methods One case of tirofiban-induced TTP was analyzed in terms of clinical manifestations, mechanisms and treatment strategies based on literature. Results Six days into tirofiban administration, the patient developed severe thrombocytopenia, bleeding, limb weakness, slowed response and microangiopathic hemolytic anemia (MAHA). In combination with bone marrow aspiration findings, these symptoms pointed to tirofiban-induced TTP. Platelet counts returned to normal eight days after drug discontinuation and symptomatic treatment. Conclusion Tirofiban may induce the risk of TTP. Platelet counts should be closely monitored when tirofiban is administered. Once TTP is suspected, the risk should be assessed or the activity of ADAMTS13 is tested for early identification and management.

Key words: Tirofiban, Thrombotic Thrombocytopenic Purpura, Microangiopathic Hemolytic Anemia(MAHA), Adverse Drug Reaction

中图分类号:

R972
R994.11

曹阳, 付晓秀, 马林. 盐酸替罗非班氯化钠注射液致血栓性血小板减少性紫癜1例分析[J]. 中国药物警戒, 2026, 23(3): 346-348.

CAO Yang, FU Xiaoxiu, MA Lin. One Case of Thrombotic Thrombocytopenic Purpura Caused by Tirofiban Hydrochloride and Sodium Chloride Injection[J]. Chinese Journal of Pharmacovigilance, 2026, 23(3): 346-348.

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参考文献

[1] China Stroke Society, Branch of Neurointervention of China Stroke Society, Interventional Group of Stroke Prevention and Control Committee of Chinese Preventive Medicine Association. Expert Consensus on the Clinical Application of Tirofiban in Atherosclerotic Cerebrovascular Diseases[J]. China Journal of Stroke(中国卒中杂志), 2019, 14(10): 1034-1044.
[2] JEONG HG, KIM BJ, YANG MH, et al.Stroke Outcomes with Use of Antithrombotics within 24 Hours after Recanalization Treatment[J]. Neurology, 2016, 87(10): 996-1002
[3] LI W, LIN L, ZHANG M, et al.Safety and Preliminary Efficacy of Early Tirofiban Treatment after Alteplase in Acuteischemic Stroke Patients[J]. Stroke, 2016, 47(10): 2649-2651.
[4] WU C, SUN C, WANG L, et al.Low-Dose Tirofiban Treatment Improves Neurological Deterioration Outcome after Intravenous Thrombolysis[J]. Stroke, 2019, 50(12): 3481-3487.
[5] CHEN ZY, YAN XX.Analysis of Tirofiban-Induced Thrombocytopenia[J]. Chinese Journal of Arteriosclerosis(中国动脉硬化杂志), 2022, 30(7): 633-639.
[6] Chinese Society of Neurology, Chinese Society of Stroke. Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke 2023[J]. Chinese Journal of Neurology(中华神经科杂志), 2024, 57(6): 523-559
[7] SUN MX, YUAN YF.Analysis of 123 Adverse Drug Reactions Induced by Tirofiban[J]. Journal of Ningxia Medical University(宁夏医科大学报), 2022, 44(12): 1267-1271.
[8] TANG Y, XU S, HUANG CL,et al.Tirofiban-Induced Severe Throm-bocytopenia after Basilar Artery Stenting[J]. Chinese Journal of Clinical Neurosurgery(中国临床神经外科杂志), 2023, 28(4): 285.
[9] WANG L, ZHANG LP, REN YJ, et al.Clinical Analysis of Tirofiban-Induced Severe Thrombocytopenia: a Case Report[J]. Adverse Drug Reactions Journal(药物不良反应杂志), 2022, 24(9): 471-477.
[10] ZHAO XZ, CUI HG.Typing of Drug-Induced Immune Thrombocytopenia and Research Progress in Diagnosis and Treatment of Tirofiban-Induced Thrombocytopenia[J]. Shandong Medical Journal(山东医药), 2022, 62(33): 102-106.
[11] NMPA. Guideline for Collection and Reporting of Individual Adverse Drug Reactions[EB/OL]. (2018-12-21)[2024-02-22]. https://www.nmpa.gov.cn/xxgk/ggtg/ypggtg/ypqtggtg/20181221172901438.html.
[12] Thrombosis and Hemostasis Group, Chinese Society of Hematology, Chinese Medical Association. Chinese Guideline for the Diagnosis and Management of Thrombotic Thrombocytopenic Purpura (2022)[J]. Chinese Journal of Hematology(中华血液学杂志), 2022, 43(1): 7-12.
[13] PAGE EE, KREMER HOVINGA JA, TERRELL DR, et al.Thrombotic Thrombocytopenic Purpura: Diagnostic Criteria, Clinical Features, and Long-Term Outcomes from 1995 through 2015[J]. Blood Adv, 2017, 1(10): 590-600.
[14] JOLY BS, COPPO P, VEYRADIER A.Thrombotic Thrombocytopenic Purpura[J]. Blood, 2017, 129(21): 2836-2846.
[15] BENDAPUDI PK, HURWITZ S, FRY A, et al.Derivation and External Validation of the PLASMIC Score for Rapid Assessment of Adults with Thrombotic Microangiopathies: a Cohort Study[J]. Lancet Haematol, 2017, 4(4): e157-e164.
[16] MASANORI M, YOSHITAKA M, KOICHI K, et al.Diagnostic and Treatment Guidelines for Thrombotic Thrombocytopenic Purpura (TTP) in Japan 2023[J]. International Journal of Hematolog, 2023, 118(5): 529-546.
[17] LI XR, WANG FM, ZHANG XL, et al.Clinical Features and Treatment Outcomes of 24 Adult Patients with Thrombotic Thrombocytopenic Purpura[J]. Chinese Journal of Nephrology(中华肾脏病杂志), 2025, 41(8): 579-586.
[18] SAID SM, HAHN J, SCHELEYER E, et al.GlycoproteinⅡb/Ⅲa Inhibitor Induced Thrombocytopenia: Diagnosis and Treatment[J]. Clin Res Cardiol, 2007, 96(2): 61-69.

盐酸替罗非班氯化钠注射液致血栓性血小板减少性紫癜1例分析

One Case of Thrombotic Thrombocytopenic Purpura Caused by Tirofiban Hydrochloride and Sodium Chloride Injection

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