非化疗药物致粒细胞缺乏症的临床特点及治疗分析

Clinical Analysis of Characteristics and Treatment of Non-chemotherapeutic induced Agranulocytosis

目的 :探讨非化疗药物致粒细胞缺乏症 (粒缺 )的临床特点 ,治疗及转归。方法 :回顾性分析 4 0例非放、化疗所致粒缺的临床资料。结果 :粒缺多发生在服用抗甲状腺药物和解热镇痛药物之后 ,应用粒细胞集落刺激因子 (G CSF)和粒 单核细胞集落刺激因子 (GM CSF)治疗粒缺可明显缩短粒细胞恢复正常的时间 ,使用亚胺培南 西司他丁 (泰能 )组体温恢复正常的时间较非泰能组明显缩短。结论 :病原学检查在粒缺治疗中有重要的指导意义。高效广谱的抗生素联合G CSF和/或GM CSF对粒缺的治疗是非常有效的。糖皮质激素治疗对粒缺的恢复似乎无明显效应。

Objective:To investigate the clinical characteristics,treatment and prognosis of agranulocytosis induced by non-chemotherapeutic medicines.Methods:Clinical data of 40 cases with agranulocytosis were analyzed retrospectively.Results:Agranulocytosis was caused mostly by anti-thyroid drugs and nonsteroidal anti-inflammatory drugs(NSAIDS).After application of G-CSF and GM-CSF for treatment of agranulocytosis,the time for neutrophil recovery was shortened.The time required for temperature return ed to normal level in the group treated with imipenem-cilastatin sodium(Tienam) was shorter than that in the group treated by antibiotics other than Tienam.Conclusions:Identification of pathogens showed important signifance for treatment of agranulocytosis.Combination application of highly efficient, wide-spectrum antibiotics and G-CSF/GM-CSF was very effective.Corticosteroids seemed to be of less value for treatment of agranulocytosis.