甲巯咪唑片引起重度粒细胞缺乏症1例并文献分析

One case report and literature review of severe agranulocytosis induced by methimazole tablets

目的分析甲巯咪唑片致重度粒细胞缺乏症的一般规律和临床特点。方法基于1例甲巯咪唑片致重度粒细胞缺乏症的病例, 检索中国知网、万方数据库和Pubmed数据库建库至2022年2月公开发表的文献, 分析甲巯咪唑致重度粒细胞缺乏症的一般规律及临床特点。结果共纳入文献44篇, 包含患者49例, 其中男性7例(14.3%), 女性42例(85.7%), 年龄(39.3±15.5)岁, 日剂量为(29.9±11.9)mg, 重度粒细胞缺乏症多发生于用药后1~3个月内, 常有高热、咽痛等症状, 大部分患者经积极治疗可好转, 但仍有部分患者因感染性休克、呼吸衰竭而死亡。结论甲巯咪唑可导致罕见的重度粒细胞缺乏症, 临床医生应注意合理用药, 以减少和避免重度粒细胞缺乏症的发生。

Objective To analyze the general rules and clinical characteristics of severe agranulocytosis caused by methimazole tablets.Methods Based on a case of severe agranulocytosis caused by methimazole tablets,the literatures on severe agranulocytosis caused by methimazole were collected from the databases of CNKI,Wanfang,and PubMed from their establishment to February 2022,and the general rules and clinical characteristics of which were statistically analyzed.Results A total of 44 literatures were included.A total of 49 patients were enrolled in this study,including 7 males(14.3%)and 42 females(85.7%),with age of(39.3±15.5)years and an average daily dose of(29.9±11.9)mg.The severe agranulocytosis usually occurred 1-3 months after medication and most patients were accompanied by high fever and sore throat.The symptoms of most patients improved after treatment,but some patients died of severe septic shock and respiratory failure.Conclusions Methimazole can cause severe agranulocytosis.Clinicians should keep a close eye on rational use of drugs so as to reduce and avoid severe agranulocytosis.