甲巯咪唑治疗甲状腺功能亢进症致白细胞减少12例临床分析

目的探讨甲巯咪唑治疗甲状腺功能亢进症引起白细胞减少的规律及治疗对策。方法回顾分析本院2007年2月至2012年2月使用甲巯咪唑治疗甲状腺功能亢进症致白细胞减少12例的临床资料。结果 75%（9/12）的病例白细胞减少发生在治疗开始的第2～3个月;全部病例白细胞减少均发生在甲巯咪唑15～45mg/d治疗阶段;口服抗白细胞减少药物及皮下注射重组人粒细胞集落刺激因子治疗的有效率为83.3%（10/12）。结论甲巯咪唑药物可导致白细胞减少、粒细胞减少;用药前后应密切监测血常规,掌握白细胞减少的情况,如明显减少应及时停药,予以升白细胞药物对症治疗,必要时给予重组人粒细胞集落刺激因子皮下注射治疗。

Clinical analysis of 12 cases of decrease of white blood cell of methimazole treatment of hyperthyroidism

Objective Regularity and therapeutic strategy of methimazole treatment of thyroid function hyperthyroidism caused leukopenia.Methods Retrospective analysis in 2007 February ～ 2012 February using methimazole treatment of hyperthyroidism induced leukopenia clinical data of 12 cases.Results 75%（9 /12）cases leukopenia occurred in the first second to 3 months; all were leukopenia occurred in 15 ～ 45 mg/d methimazole treatment phase; oral anti leukocyte reduction of drug and subcutaneous injection of recombinant human granulocyte colony stimulating factor treatment effective rate was 83.3%（10 /12）.Conclusion Methimazole drugs can cause leukopenia,neutropenia; before and after medication should closely monitor blood,grasp the white blood cells reduced,such as reduced obviously should be promptly discontinued,be leukogenic drugs symptomatic treatment,treated with recombinant human granulocyte colony-stimulating factor hypodermic injection treatment when necessary.