关键词: 老年人, 替罗非班, 血小板减少症, 糖皮质激素, 免疫球蛋白, 血小板恢复

Abstract: Objective To evaluate the therapeutic effects of glucocorticoids and(or) immunoglobulins in the elderly patients with tirofiban-induced severe thrombocytopenia. Methods The clinical data, usage and dosage of glucocorticoid/immunoglobulin, the change of platelet (PLT), the incidence of various bleeding events of 29 cases of elderly patients with severe tirofiban-induced thrombocytopenia admitted to Department of Cardiology, TEDA International Cardiovascular Hospital from September 2008 to September 2023 were retrospectively collected. All patients were divided into elderly group (n=18) and non-elderly group (n=11). Each group was further divided into treatment subgroup (receiving glucocorticoids and/or immunoglobulins) and control subgroup. The time to PLT recovery (normalization), the baseline value and the lowest value of PLT, the incidence of various bleeding events were compared among the groups. Linear regression analysis was employed to examine the interaction between age and treatment. Results Baseline characteristics, lowest value and baseline value of PLT, and usage and dosage of glucocorticoid/immunoglobulin showed no significant differences between elderly group and non-elderly group (P>0.05). In the elderly patients, there were no significant differences in the baseline value and lowest value of PLT between treatment subgroup and control subgroup (P＞0.05), but the PLT recovery time was significantly shorter in the treatment subgroup than that in the control subgroup (P＜0.05). In non-elderly patients, there were no significant differences in the above indicators between treatment subgroup and control subgroup (P＞0.05). Multivariate linear regression analysis revealed a significant interaction between age and immunosuppressive therapy (P<0.05). Immunosuppressive treatment significantly reduced the time to normalization of PLT in the elderly patients (P <0.05), while showing no significant impact in non-elderly patients (P>0.05). No statistically significant difference in the incidence of bleeding events was observed among the groups (P>0.05). Conclusions Glucocorticoids and (or) immunoglobulins can significantly accelerate PLT recovery in the elderly patients with tirofiban-induced severe thromocytopenia.

Key words: aged, tirofiban, thrombocytopenia, glucocorticoids, immunoglobulin, platelet recovery