抗甲状腺药物致粒细胞缺乏患者骨髓象特点及相关临床资料分析

Analysis of myelogram characteristics and clinical data of antithyroid drugs induced agranulocytosis patients

目的分析抗甲状腺药物(ATD)治疗导致粒细胞缺乏症患者骨髓象特点及相关临床资料,探索骨髓象特点与粒细胞恢复情况及临床预后的关系。方法对33例服用抗甲状腺药物导致粒细胞缺乏的住院患者骨髓检查结果及临床资料进行回顾性分析。结果 33例粒缺患者中骨髓象为成熟障碍型13例(39.4%)、再生障碍型20例(60.6%),成熟障碍型患者粒细胞上升至正常平均(4.7±1.0)d,而再生障碍型为(8.0±2.8)d,发热天数成熟障碍型(3.6±2.5)d,再生障碍型为(8.6±3.1)d,2例死亡患者均为再生障碍型。结论 ATD导致粒细胞缺乏骨髓象以再生障碍型为主。成熟障碍型较再生障碍型患者粒细胞恢复快,发热时间短,预后好。

【Objective】Analysis of myelogram characteristics and some related clinical data to explore the relationship between bone marrow characteristics and clinical prognosis of antithyroid drugs induced agranulocytosis.【Methods】The bone marrow characteristics and clinical data of 33 hospitalized cases were retrospectively analyzed.【Results】There were 13 cases（39.4%） with myelogram charactered as dysmaturity and 20 cases（60.6%） as aregeneratory.The median duration of neutrophil recovery and fever were（4.7±1.0） and（3.6±2.5） days in dysmaturity type while（8.0±2.8） and（8.6±3.1） days in aplastic type.Two cases in aplastic type group died of infection.【Conclusions】The myelogram charactered mainly as aplastic type in antithyroid drug induced agranulocytosis patients.Patients in dysmaturity type group are usually with good clinical prognosis for quickly increased neutrophil and short duration of fever.