抗甲状腺药致粒细胞缺乏症18例回顾性分析

Retrospective Analysis of 18 Cases with Agranulocytosis Induced by Antithyroid Drugs

目的分析常规白细胞计数对预测抗甲状腺药物致粒细胞缺乏症的意义及抗甲状腺药物致粒细胞缺乏症的危险因子。方法回顾性分析18例抗甲状腺药致粒细胞缺乏(粒缺)的临床资料。结果和结论粒缺乏多数发生在服药后2～12周。且与抗甲状腺药物剂量有关。有些患者的粒缺发生是突然的,每1～2周白细胞和粒细胞计数也不能预测某些粒缺的发生。抗甲状腺药物治疗维持剂量时,不需作常规白细胞检查。粒、巨噬细胞集落刺激因子治疗对粒细胞恢复是有效的,糖皮质激素治疗对粒缺的恢复似乎无明显效应。

Objective To analyse the routine WBC count's effect on predicting antithyroid drugsinduced agranulocytosis developing and risk factors of antithyroid drugs-induced agranulocytosis. Methods retrospective analysis of 18 Graves' cases with agranulocytosis induced by antithyroid drugs during 1984～1995. Results and Conclusions Most of antithyroid drugsinduced agranulocytosis happens 2～12 weeks after the administration of antithyroid drug, and are related with the drug's doses. Some agranulocytosis happens abruptly, routine WBC and granulocyte count can not predict some agranulocytosis developing. Fever and throat sore are the intitial symptoms of agranulocytosis, if it happens, the WBC and granulocyte count must be checked immediately. The treatment of granulocyte-macrophage colony stimulating factor is effective, the corticosteroid therapy seems not to be useful for the recovery of granulocyte count.