甲状腺功能亢进症合并血细胞减少症29例临床分析

回顾性分析29例甲状腺功能亢进症（甲亢）合并血细胞减少患者的临床资料。血细胞减少5例于甲亢治疗前出现、24例为行抗甲状腺药物治疗后出现。17例使用甲巯咪唑、7例服用丙硫氧嘧啶治疗，多发生于服药后半年内，与剂量相关。20例患者在血细胞上升后行^131I治疗甲亢，血细胞均稳定。提示血细胞减少多发生在抗甲状腺药物治疗早期，与药物种类、剂量有关，^131I对抗甲状腺药物所致血细胞减少症者的甲亢后续治疗较为安全。

Clinical analysis of 29 hyperthyroid patients combined with cytopenia

This report was to retrospectively analyze clinical data of 29 hyperthyroid patients with concurrent hematocytopenia.Our findings demonstrated that 5 patients developed cytopenia without any antithyroidism drugs(ATDs),while the other 24 cytopenia patients were only found after taking ATD.In the drug intervention group,17 patients received methimazole(MMI)and 7 took propylthiouracil(PTU).Most cytopenia was dose-dependent and occurred within the first 6 months of medication.Twenty subjects received radioiodine therapy,with no impact on blood cells.We suggested that cytopenia might occur at the early stage of ATD therapy and be related with drug and its dose.Blood cell amount should be monitored,especially for initial ATD therapy.As for interaction between PTU and MMI,alternative radioiodine therapy might seem to be relatively safe.