抗甲状腺药物致粒细胞缺乏症46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病因、临床特点、诊治方法。方法:对我院收治的46例因服用ATD致粒细胞缺乏症患者的临床资料进行回顾性分析。结果:粒细胞缺乏症多数发生在服药后2~8周。他巴唑(MMI)组的发病时间及粒细胞值较丙基硫氧嘧啶(PTU)组之间无统计学意义(P>0.05)。多数病例有咽痛、发热等临床症状。所有患者停用ATD,选择性使用升白细胞药、糖皮质激素、粒细胞集落刺激因子(G-CSF),症状均好转。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,以便尽早发现,及时治疗。重症病例应加用G-CSF。

Clinical Analysis of 46 Patients with Agtranulocytosis Induced by Antithyroid Drugs

Objective:To investigate the clinical features,the diagnosis and treatment of agranulocytosis induced by antithyroid drugs.Methods:The clinical data of 46 patients with agranulocytosis induced by antithyroid drug in our hospital were retrospectively analyzed.Results:In most cases,agranulocytosis occurred between 2 to 8 weeks after the drug administration.There were no significant differences in the emergence time and the number of granulocges between Methimazole(MMI) group and Propyl thiouacil(PTU) group(P>0.05).Most of them had fever or pharyngalgia.After stopped using ATDS and received the treatment of glucocorticoid and G-CSF,they were recovered.Conclusion:We should monitor the leucocytes of the patients who were using the ATD especially in the first 2 months in order to find out and treat the agranulocytosis in time.In severe cases,G-CSF is necessary.