粒细胞缺乏症的临床特点及实验室检查

目的：探讨粒细胞缺乏症（粒缺）的临床及实验室检查特点。方法：对我院10年内收治的67例粒缺住院患者,回顾分析其临床资料、外周血常规、骨髓象及病原学检查的结果。结果：67例中,以药物性的粒缺和感染性粒缺为主,分别为41例（61.2%）和16例（23.9%）。白细胞计数为（0.36-1.79）×10^9/L,骨髓增生程度从减低到明显活跃;病原学检查26例,其中血培养10例,阳性率20.0%;咽拭子培养16例,阳性率12.5%;粒缺治疗中除了抗感染、并发症的对症处理、加强环境保护及规范化护理外,57例患者使用了粒细胞集落刺激因子（G-CSF）,10例使用利血生、强力升白片、鲨肝醇等治疗。治愈19例、好转45例、自动出院2例、死亡1例。结论：药物和感染可能是导致粒细胞缺乏症的直接诱因,同时加强病原学检查有助于粒细胞缺乏症的治疗。

Clinical features and laboratory detection of agranulocytopenia

Objective：To investigate the clinical features and laboratory characteristics of agranulocytopenia.Method：Clinical data,peripheral blood routine test,myelogram and pathogenic diagnosis of 67 patients with agranulocytopenia in the past 10 years were analyzed retrospectively.Result：Among 67 patients,drug-induced and infection-induced agranulocytopenia were 41 cases（61.2%） and 16 cases（23.9%）,respectively.White blood cell count was（0.36～1.79）×10^9/L.Bone marrow hyperplasia degree was from hypoplasia to obvious hyperplasia.The positive rate of pathogenic diagnosis was relatively low,and positive rate of blood culture was 20.0%（10 cases） and throat swab culture was 12.5%（16 cases）.Besides anti-infection treatment symptomatic therapy of complications,environment protection and standard nursing care,57 patients received granulocyte colony-stimulating factor（G-CSF）,10 patients received Leucogen,Qiang Li Shen Bai Tablet and batilol.19 patients were cured,45 were improved,2 discharged against advice and 1 died.Conclusion：Drugs and infection may be direct causes of agranulocytopenia.And it would be helpful to strengthen pathogenic diagnosis for the treatment of agranulocytopenia.