抗甲状腺药物致粒细胞缺乏症17例临床分析

目的　探讨抗甲状腺药物 (ATD)引起粒细胞缺乏症的临床特点 ,治疗及转归。方法　对 17例因服用ATD致粒细胞缺乏症患者进行回顾性分析。结果　单独应用糖皮质激素氢化可的松 (HCSS)和联合应用重组人粒细胞集落刺激因子 (G CSF)均有效 ,有效率达 10 0 % ,但HCSS与G CSF联合应用效果更明显 ,粒细胞恢复正常时间更短。 17例患者中 ,82 9%的粒细胞缺乏症发生在ATD治疗后的 2个月以内。结论　对服用ATD者均应常规监测外周血白细胞 ,尤其在开始治疗的前 2个月 ,以尽早发现 ,及时治疗。HCSS和G CSF治疗ATD所致粒细胞缺乏症疗效肯定 ,但对重症病例 ,应用HCSS与G CSF联合治疗优于单独应用HCSS治疗 ,若合并感染 ,应加用抗生素。

Clinical analysis of 17 patients with agranulocytosis induced by anti-thyroid drug

Objective To investigate the clinical character,treatment and prognosis of agranulocytosis induced by anti-thyroid drug(ATD).Methods 17 patients with agranulocytosis induced by ATD were analysed retrospectively.Results Effective rates of agranulocytosis treatment with glucocorticoid(HCSS) or combined HSCC and granulocyte colony-stimulating factor(G-CSF) were 100%,but the recovery time of granulocyte was shorter in the group with HCSS and G-CSF in comparion with singe HCSS treated group.Among 17 patients,82.9% agranulocytosis occurred within two months after ATD treatment.Conclusion HCS and G-CSF have certain efficacy for treating agranulocytosis induced by ATD,but combined HCSS and G-CSF therapy is superior to the singe HCSS therapy in serious patients;Peripheral white cell should be mornitored periodically during the ATD treatment,especially in early stage.