目的探讨阿加曲班抗凝联合阿替普酶溶栓治疗急性下肢深静脉血栓(DVT)合并肝素诱导血小板减少症(HIT)患者的临床疗效。方法回顾性分析6例急性DVT合并HIT患者的临床资料,均为使用肝素治疗DVT期间出现血小板减少合并血栓范围扩大,立即停用肝素,给予阿加曲班抗凝治疗,同时给予阿替普酶置管溶栓治疗。结果对6例HIT患者行阿加曲班联合阿替普酶溶栓综合介入治疗均有效,4例下肢肿胀完全消失,2例症状明显缓解。随访6~24个月,6例患者DVT均无复发。结论对于急性DVT接受肝素治疗后高度怀疑HIT者,应立即停用肝素,改用阿加曲班等替代抗凝药物,对于血栓范围扩大而尿激酶溶栓治疗无效者,可考虑改用阿替普酶溶栓治疗。 Objective To investigate the clinical efficacy of argatroban combined with alteplase thrombolysis in patients with acute lower extremity deep vein thrombosis (DVT) and heparin-induced thrombocytopenia (HIT). Methods The clinical data of 6 patients with acute DVT complicated with HIT were retrospectively analyzed. All of them were patients with thrombocytopenia and thrombosis expanding during the treatment of DVT with heparin. Heparin was withdrawn immediately and anticoagulant therapy was given. Altretrase Pipette thrombolytic therapy. Results Six cases of HIT patients were treated with arquat and thrombolytic combined with alteplase were effective interventional treatment, 4 cases of lower extremity swelling disappeared completely, 2 cases of symptoms were relieved. All cases were followed up for 6-24 months. No recurrence was found in 6 cases of DVT. Conclusions For those patients with high suspicion of HIT after acute DVT receiving heparin therapy, heparin should be discontinued immediately instead of anticoagulant drugs such as argatroban. For patients with enlarged thrombus and no urokinase thrombolytic therapy, Enzyme thrombolytic therapy.