甲巯咪唑致严重粒细胞缺乏2例并严重不良反应文献分析

Literature analysis of 2 cases of severe agranulocytosis caused by methimazole and serious adverse reactions

目的分析甲巯咪唑致严重不良反应,为临床安全用药提供参考。方法基于湖北民族大学附属民大医院发生的甲巯咪唑致严重粒细胞缺乏患者2例,检索CNKI、万方、pubmend等数据库,查阅甲巯咪唑导致的严重不良反应病例,分析其表现及可能存在的原因。结果甲巯咪唑致严重不良反应主要集中在血液系统、骨和关节系统、消化系统、皮肤等,主要表现为粒细胞缺乏、肝功能受损、大泡性皮疹、关节痛、抽搐、罕见间质性肺炎等。结论甲巯咪唑致严重不良反应不容忽视,临床使用时应严密监测血常规、肝肾功能、肌酸激酶等,对患者宣传用药安全知识,加强自我监测,以确保用药安全。

Objective To analyze the serious adverse reactions caused by methimazole and provide some reference for clinical safety.Methods Based on 2 patients with severe agranulocytosis caused by methimazole in the Minda Hospital affiliated to Hubei Minzu University.Databases such as CNKI,Wanfang and Pubmend were searched for cases of severe adverse reactions caused by methimazole,and their manifestations and possible causes were analyzed.Results Severe adverse reactions caused by methimazole were mainly concentrated in the blood system,bone and joint system,digestive system,skin,etc.,mainly manifested as agranulocytosis,impaired liver function,bullous rash,joint pain,convulsions,and rare interstitial Pneumonia etc.Conclusion Serious adverse reactions caused by methimazole should not be ignored.During clinical use,blood routine,liver and kidney function,creatine kinase,etc.,should be closely monitored,and drug use should be well confessed and self-monitoring should be strengthened to ensure the safety of drug use.