药物诱导的粒细胞缺乏症研究进展

粒细胞缺乏症是一种罕见且潜在威胁生命的疾病，70%~90%的粒细胞缺乏症是由药物引起的。药物诱导的粒细胞缺乏症（drug-induced agranulocytosis，DIAG）的特征是循环粒细胞显著减少或绝对缺乏，中性粒细胞绝对值<0.5×10⁹·L^-1。DIAG几乎涉及所有品类的药品，其中风险较高的药物包括抗甲状腺药物、抗精神病药物和抗感染药物。DIAG是由于个体特有的易感性而对药物产生的不良反应，通常与给药剂量无关。DIAG的发病机制与直接细胞毒性、免疫反应以及遗传易感性密切相关。及时停止可疑药物、使用广谱抗菌药物以及考虑在高危患者中使用造血细胞生长因子对降低DIAG的死亡率至关重要。

Research Progress in Drug-induced Agranulocytosis

Agranulocytosis is a rare and potentially life-threatening disease, which is attributable to drugs in about 70%-90% of cases. Drug-induced agranulocytosis(DIAG) is characterized by a remarkable decrease or an absolute lack of circulating granulocytes, with a neutrophil count of<0.5×10⁹·L^-1 in blood circulation. Almost all classes of drugs have been implicated with DIAG, but the high risk is only associated with several kind of drugs, such as antithyroid drugs, psychotropic agents and antibiotics. DIAG is an adverse reaction to the drug due to individual-specific susceptibility, and is usually not associated with the administered dose. The pathological mechanism of DIAG is related to direct cytotoxicity, immune reaction and genetic susceptibility. Immediate discontinuation of the suspected drug, initiation of broad-spectrum antibiotics and consideration of the use of haematopoietic cell growth factors in high-risk patients are critical to reducing the mortality of DIAG.