丙基硫氧嘧啶致粒细胞减少症64例临床分析

目的 了解丙基硫氧嘧啶（PTU）致粒细胞减少症的发病情况、临床表现及治疗对策。方法 对近2年门诊有完整记录的64例PTU致粒细胞减少症的临床特征及治疗情况进行统计分析。结果 粒细胞减少症多数发生在服药后2～8周，且与PTU的剂量有关。多数病例有头昏、乏力的临床症状。全部病例继续使用PTU，加用口服升白药或皮下注射粒细胞集落刺激因子（G-CSF），粒细胞均恢复正常，无1例发生粒细胞缺乏症。结论 PTU起始剂量不宜超过300mg／d，使用头1、2个月内应密切观察外周血白细胞计数，口服升白药或注射G-CSF对白细胞恢复是有效的，并可避免粒细胞缺乏症的发生。

Clinical analysis of 64 cases with propylthiouracil-induced granulocytopenia

[Objective] To clarify the onset,development,clinical manifestations and management of propylthiouracil(PTU)-induced granulocytopenia.[Methods] 64 outpatients with PTU-induced granulocytopenia,who had complete medical records and were encountered during the past two years,were statistically analyzed in terms of their clinical features and treatment.[Results] In most cases the granulocytopenia occurred between 2 to 8 weeks after the drug administration and was related to the dose of PTU.Clinically the majority of the patients developed dizziness and weakness.All the subjects continued to use PTU and simultaneously received leukogenic agents or subcutaneous injection with granulocyte colony-stimulating factor(G-CSF).As a result granulocytes were restored to the normal in all the cases and none progressed into agranulocytosis.[Conclusions] The initial dose for PTU is proposed not to exceed 300 mg per day.And the peripheral leucocytes should be closely monitored especially within 1 to 2 months after PTU treatment.Either oral leukogenic agents or injectile G-CSF is effective for the leucocytes normalization,thus preventing the occurrence of agranulocytosis.