利福平主要用于结核病的治疗，能引起血小板减少等不良反应。本病例使用利福平后出现严重血小板减少，血小板下降至4×10⁹/L，立即停用利福平并输注血小板后血小板恢复正常。因此，在利福平使用过程中应密切观察病情，监测血常规、肝肾功能等，及时发现不良反应，必要时立即停药，并对血小板明显下降者(<30×10⁹/L)给予补充血小板等治疗。对明确由利福平引起血小板减少者，治疗时应不再使用该药，以避免药物不良事件的发生。

Rifampicin is mainly used for the treatment of tuberculosis. Early studied indicated it can cause adverse reactions such as thrombocytopenia in clinical applications, and we reported a severe thrombocytopenia in this case. Following the use of rifampicin, patient’s platelet count decreased to 4×10⁹/L. After immediate withdrawal of rifampicin plus other treatments, platelet count returned to the normal. The case suggested that in the process of rifampicin treatment, side effects should be closely observed. Routine blood biochemical examination, liver and kidney function should be monitored. When platelet count significantly decreased (less than 30×10⁹/L), rifampicin should be withdrawn immediately, and supplementary treatment such as platelet infusion should be given, and rifampicin should not be administered to such patients any more.