بروز ترومبوسیتوپنی ناشی ازهپارین، در دو روش تجویز داخل وریدی در بیماران با سندرم حاد کرونری

  Incidence of Thrombocytopenia Induced by Two Methods of Intravenous Heparin injection in Patients with Acute Coronary Syndrome.     H. Nough MD1* , A. Khodadadi Zadeh MSc2, M. Aref 3, A. Esmaieli ‌ Nadimi MD1     1- Assisstant Professor of Cardiology, University of Medical Sciences, Rafsanjan, Iran   2- Academic Member, Dept. of Nursing, Faculty of Nursing Midwifery, University of Medical Sciences, Rafsanjan, Iran   3- Pharm D Student, Faculty of Pharmacology, University of Medical Sciences, Kerman, Iran     Background: Intravenous heparin is an effective treatment in patients with acute coronary syndrome, and administrered either by 6 hours bolus intravenus injection or continuous in fusion. Thrombocytopenia induced by heparin injection have been reported 0-30%, that is variable by different methods of heparin administration. This study was carried out to determine the incidence of thrombocytopenia in both methods of intravenous heparin administration in patients referred to CCU of Aliebn Abitaleb Hospital, Rafsanjan.   Materials and Methods: This clinical trial was carried out in 64 patient (35male and 29 female) with mean age of 52±6 years who admitted in CCU with acute coronary syndrome .   32 patients received continuous infusion (group A) and 32 patients recievd intermittent intravenous bolus injection of heparin every six hours (group B). Because of hospitalization duration of shorter than 24 hours, 4 patients (2 males and 2 females) from group B and 1 (male) from group A excluded from the study. Dosage of heparin adjusted based on body weight and Aptt measurement of 1.5-2 times of control levels. CBC and platelet count was done on the day of admission, 3 and 7 days after heparin administration.   Results: There were not significant differences between two groups for age, sex and total amounts of prescribed heparin. There were 4 (14.8%) cases with thrombocytopenia in-group B, and one cases (3.1%) in group A, this difference was significant statistically (p<0.05). There was no significant difference in platelet count in group A (210000±20000/mm3) compare to group B (208000±18000/mm3).   Conclusion: Thrombocytopenia induced by heparin, was significantly lower in continuous infusion of heparin compare to intermittent intravenous bolus injection. Therefore continuous infusion of heparin is recommended for patients with acute coronary syndrome who needs heparin therapy .     Key words: Thrombocytopenia, Acute coronary syndrome, Intravenous infusion of heparin, Heparin intravenous blous injection   * Corresponding author:Tel: (0391)8220024 , Fax:(0391)5228497, E-mail: hnough@ yahoo.com   Journal of Rafsanjan University of Medical Sciences and Health Services, 2005, 4(1): 9-16