肝素引起阴茎异常勃起机制的研究

摘要

目的:探讨肝素引起阴茎异常勃起的机制.方法:分析临床及文献报道的55例应用肝素或低分子肝素后出现异常勃起患者临床表现、实验室检查及治疗方法;结合已知的肝素药理作用及不良反应,总结出肝素引起阴茎异常勃起的原因.结果:55例患者中应用肝素53例、低分子肝素2例;临床表现均符合缺血性异常勃起;用药24h内发生异常勃起17例,均为长期血液透析病例,其他病例为应用肝素或低分子肝素后3～15d,平均7.4d;患者血小板计数正常35例,低于正常8例.结论:应用肝素后可以出现抗血小板因子4与肝素复合物抗体.抗体促进血小板聚集而诱发静脉血栓形成是引起阴茎异常勃起的主要原因.%Objectives:To study the mechanism of priapism caused by heparin.Methods:The clinical manifestation,laboratory examination and treatment methods of 55 priapism patients using heparin or low-molecular-weight heparin in the clinical and literature reports were studied.The most likely reasons or mechanism were summarized,considering the pharmacological effects and adverse reactions of heparin.Results:There were 53 cases using heparin and 2 cases using low-molecular-weight heparin in the 55 patients.Within 24 hours after the meditation,17 cases experienced priapism,all being long-term hemodialysis cases.The rest had priapism 3 to 15 days after using heparin or low-molecular-weight heparin,an average of 7.4 days.38 patients were with normal platelet count and the counts of 5 cases were below the normal range.Conclusion.Platelet factor 4 (PF4) and H-PF4 antibody appear after using heparin.The major mechanism causing priapism is through the evoked venous thrombosis facilitated by platelet aggregation.