Leukopenia-a rare complication secondary to invasive liver abscess syndrome in a patient with diabetes mellitus:A case report

BACKGROUND Thrombocytopenia is a common complication of invasive liver abscess syndrome(ILAS)by Klebsiella pneumoniae(K.pneumoniae)infection,which indicates severe infection and a poor prognosis.However,the presence of leukopenia is rare.There are rare reports on leukopenia and its clinical significance for ILAS,and there is currently no recognized treatment plan.Early and broad-spectrum antimi-crobial therapy may be an effective therapy for treating ILAS and improving its prognosis.CASE SUMMARY A 55-year-old male patient who developed fever,chills,and abdominal distension without an obvious cause presented to the hospital for treatment.Laboratory tests revealed thrombocytopenia,leukopenia,and multiple organ dysfunction.Imaging examinations revealed an abscess in the right lobe of the liver and thromboph-lebitis,and K.pneumoniae was detected in the blood cultures.Since the patient was diabetic and had multi-system involvement,he was diagnosed with ILAS accom-panied by leukopenia and thrombocytopenia.After antibiotic treatment and sys-temic supportive therapy,the symptoms disappeared,and the patient’s condition almost completely resolved.CONCLUSION Leukopenia is a rare complication of ILAS,which serves as an indicator of adverse prognostic outcomes and the severity of infection.

Nucleoside diphosphate-linked moiety X-type motif 15 R139C genotypes impact 6-thioguanine nucleotide cut-off levels to predict thiopurine-induced leukopenia in Crohn’s disease patients

BACKGROUND Thiopurine-induced leukopenia(TIL)is a life-threatening toxicity and occurs with a high frequency in the Asian population.Although nucleoside diphosphate-linked moiety X-type motif 15(NUDT15)variants significantly improve the predictive sensitivity of TIL,more than 50%of cases of this toxicity cannot be predicted by this mutation.The potential use of the 6-thioguanine nucleotide(6TGN)level to predict TIL has been explored,but no decisive conclusion has been reached.Can we increase the predictive sensitivity based on 6TGN by subgrouping patients according to their NUDT15 R139C genotypes?AIM To determine the 6TGN cut-off levels after dividing patients into subgroups according to their NUDT15 R139C genotypes.METHODS Patients’clinical and epidemiological characteristics were collected from medical records from July 2014 to February 2017.NUDT15 R139C,thiopurine S methyltransferase,and 6TGN concentrations were measured.RESULTS A total of 411 Crohn’s disease patients were included.TIL was observed in 72 individuals with a median 6TGN level of 323.4 pmol/8×10^8 red blood cells(RBC),which was not different from that of patients without TIL(P=0.071).Then,we compared the 6TGN levels based on NUDT15 R139C.For CC(n=342)and CT(n=65)genotypes,the median 6TGN level in patients with TIL was significantly higher than that in patients without(474.8 vs 306.0 pmol/8×10^8 RBC,P=9.4×10-^5;291.7 vs 217.6 pmol/8×10^8 RBC,P=0.039,respectively).The four TT carriers developed TIL,with a median 6TGN concentration of 135.8 pmol/8×10^8 RBC.The 6TGN cut-off levels were 411.5 and 319.2 pmol/8×108 RBC for the CC and CT groups,respectively.CONCLUSION The predictive sensitivity of TIL based on 6TGN is dramatically increased after subgrouping according to NUDT15 R139C genotypes.Applying 6TGN cut-off levels to adjust thiopurine therapies based on NUDT15 is strongly recommended.

Prognostic value of chemotherapy-induced leukopenia in small-cell lung cancer

Objective: Chemotherapy is the standard treatment for small-cell lung cancer (SCLC), and leukopenia is a common side effect. This study assesses whether chemotherapy-induced leukopenia is a predictor of efficacy and whether it is associated with the survival of SCLC patients. Methods: A retrospective analysis was conducted on data from 445 patients with SCLC who received standard chemotherapy for 4 to 10 cycles. The World Health Organization grading system classifies leukopenia during chemotherapy as follows: absent (grade 0), mild (grades 1 and 2), or severe (grades 3 and 4). The primary endpoint is overall survival (OS). Results: The association between chemotherapy-induced leukopenia and OS was assessed. According to a multivariate Cox model with time-varying covariates, the hazard ratio of death was significantly lower among patients with mild leukopenia than among patients with severe leukopenia at 0.687 (0.506 to 0.943) and 1.414 (1.147 to 1.744), respectively. The median survival was 13 months (95% CI: 11 to 15 months) for patients who did not experience leukopenia, 17 months (95% CI: 14 to 18 months) for those with mild leukopenia, and 14 months (95% CI: 13 to 16 months) for those with severe leukopenia (absent vs. mild vs. severe leukopenia, P=0.047). Conclusion: Leukopenia during chemotherapy is associated with the survival of SCLC patients. Mild leukopenia is strongly associated with longer survival time.

Analysis of the Therapeutic Effect of Sodium Copper Chlorophyllin Tablet in Treating60Cases of Leukopenia

Objective： To evaluate the efficacy and safety of sodium copper chlorophyllin （trademarked as ＂Yebaike Tablet （叶拜克） which is abbreviated as YBK in treating leukopenia. Methods： One hundred and five patients with leukopenia caused by various factors were randomized into 3 groups. The 60 patients in the YBK group took orally YBK Tablets at the dose of 40 mg, three times per day, the 30 patients in the leucogen group were treated with Leucogen Tablets （利血生片） at the dose of 20 mg, three times per day, and the 15 patients in the placebo group were administered with vitamin C tablets 100 mg, three times per day. All the subjects were treated for 1 month. The change of peripheral leucocytes count after treatment and adverse drug reaction that occurred in patients were studied. Results： In the 60 patients treated with YBK, the treatment proved to be markedly effective in 34 cases, effective in 17 and ineffective in 9, the total effective rate being 85%, which was significantly higher than that in the placebo group （26.7%, P〈0.01） and similar to that in the leucogen group （83.3 %, P〉0.05）. No adverse reaction was found in the treatment course. Conclusion： YBK can be used in the treatment of leukopenia caused by various factors, satisfactory in efficacy and safe in use.

Incidence of leukopenia after intraperitoneal vs combined intravenous/intraperitoneal chemotherapy in pseudomyxoma peritonei

AIM: To investigate the clinical impact of post-hyperthermic intraperitoneal chemotherapy(HIPEC) leukopenia, intraperitoneal and combined intravenous/intraperitoneal drug administrations were compared.METHODS: Two patient cohorts were retrospectively analyzed regarding the incidence of postoperative leukopenia. The first cohort(n = 32) received Mitomycin C(MMC)-based HIPEC intraperitoneally(35 mg/m2 for 90 min) and the second cohort(n = 10) received a bidirectional therapy consisting of oxaliplatin(OX)(300 mg/m2 for 30 min) intraperitoneally and 5-fluorouracil(5-FU) 400 mg/m2 plus folinic acid 20 mg/m2 intravenously. The following data were collected retrospectively: Age, sex, length of operation, length of hospital stay, amount of resection including extent of peritonectomy, peritoneal cancer index, CC(completeness of cytoreduction)-status and leukocyte-count before cytoreductive surgery(CRS) and HIPEC, on days 3, 7 and 14 after CRS and HIPEC. HIPEC leukopenia was defined as < 4000 cells/m3. RESULTS: Leukopenia occurred statistically more often in the MMC than in the OX/5-FU-group(10/32 vs 0/10; P = 0.042). Leukopenia set-on was on day 7 after CRS and MMC-HIPEC and lasted for two to three days. Three patients(33%) required medical treatment. Patients affected by leukopenia were predominantly female(7/10 patients) and older than 50 years(8/10 patients). Thelength of hospital stay tended to be higher in the MMCgroup without reaching statistical significance(22.5± 11 vs 16.5 ± 3.5 d). Length of operation(08:54 ± 01:44 vs 09:48 ± 02:28 h) were comparable between patients with and without postoperative leukopenia. Prior history of systemic chemotherapy did not trigger postHIPEC leukopenia. Occurrence of leucopenia did not trigger surgical site infections, intraabdominal abscess formations, hospital-acquired pneumonia or anastomotic insufficiencies. CONCLUSION: Surgeons must be aware that there is a higher incidence of postoperative leukopenia in MMCbased HIPEC protocols primarily affecting females and older patients.

Treatment of 104 Cases of Chemotherapy-Induced Leukopenia by Injection of Drugs into Zusanli

From April 1992 to April 1998, 104 cases of chemotherapy-induced leukopenia were treated by injection into Zusanli (ST 36) with a mixture consisting of dexamethasone, 654-2, ATP and inosine. The therapeutic results were satisfactory as reported in the following.Clinical Data In this series, all the 127 cases were definitely diagnosed by pathological examination. Of them, 93 were male and 34 female, ranging in age from 12 to 75 years. 38 cases were carcinoma of esophagus, 22 carcinoma of cardia of stomach, 21 cancer of lung, 11 hepatic carcinoma, 8 lymphoma, 8 mammary cancer, 7 carcinoma of colon, and 12 other kinds of the tumors. Leukocyte count was below 4.0×109/L in all the patients after being treated by chemotherapy.

Ascertainment Corrected Prevalence Rate (ACPR) of Leukopenia in Workers Exposed to Benzene in Small-Scale Industries Calculated With Capture-Recapture Methods

ACPRs of leukopenia in peripheral blood of workers exposed to benzene in small-scale industries are calculated using capture-recapture methods. The results from two figures with 6-month apart demonstrate that the ACPR in workers exposed to benzene is 36.81(29. 14-44.48)%, significantly higher than that of control 12.71(7.20-18.22)% (P<0.05),with a relative risk of 2.9. The prevalences of 4 cross-sectional investigations in exposure group calculated with routine method are 18.73%, 26.37%, 27.93%, and 36.76% respectively;in controls, 8.38%, 6.85%, 7.94%, and 15.00% respectively and all fall in the range of 95% CI of ACPR. It is suggested that the methods of calculating ACPR by capture-recapture methods is simple, feasible and efficient, with the results more precise than with traditional methods.

CLINICAL OBSERVATION ON THERAPEUTIC EFFECT OF ACUPUNCTURE AT ZUSANLI FOR LEUKOPENIA

In recent years, leukopenia is clinically very common. The leukopenic patient is significantly low in immunocompetence and is likely to suffer from various kinds of infections. Zusanli (St 36), an

原发性干燥综合征合并血细胞减少中医诊治研究进展

原发性干燥综合征(pSS)是一种慢性炎症性自身免疫病,除累及外分泌腺之外,还可累及多器官、系统,其中以血液系统受累最为常见,多表现为一系或多系血细胞减少。目前对于pSS合并血细胞减少缺乏统一公认的治疗方案,西医治疗多以糖皮质激素、免疫抑制剂为主,而中医药治疗本病具有较好疗效。通过总结pSS合并血细胞减少的中医诊治经验,并对相关研究进行综述后发现,现代医家认为pSS核心病机为气阴亏虚,久之则产生热、毒、瘀等多种病理产物,相互影响,导致全身气血津液失常,引起血细胞减少。本病病位多责之于肝、脾、肾,治以滋阴、益气、养血之法,辅以清热解毒、化瘀通络之法,并根据其合并血细胞减少类型的不同以及是否使用糖皮质激素用药各有侧重。中医药治疗本病较西药治疗能够更好地改善血细胞水平且不良事件发生率更低,具有一定优势。

芪胶升白胶囊治疗白细胞减少症的作用机制研究

运用网络药理学结合分子对接技术探讨芪胶升白胶囊治疗白细胞减少症的作用机制.通过中药系统药理学数据库与分析平台数据库(TCMSP)和SwissTargetPrediction数据库综合相关文献报道获得芪胶升白胶囊功能靶标,在GeneCards数据库中获取白细胞减少症的治疗靶点,并对两者取交集靶点后,在DAVID数据库中进行基因本体论(GO)功能和京都基因与基因组百科全书(KEGG)通路富集分析.收集我院住院期间使用芪胶升白胶囊的白细胞减少症患者,比较使用前、后白细胞水平变化.采用动物实验验证网络药理学预测芪胶升白胶囊治疗白细胞减少症的核心靶点.芪胶升白胶囊与白细胞减少症交集靶点有124个,GO富集分析主要在基因表达调控、凋亡过程、细胞增殖等方面,KEGG富集分析主要在PI3K-Akt信号、细胞衰老、TNF信号通路、细胞凋亡、IL-17信号通路、NF-kappa B信号通路等方面.通过“药物-活性成分-靶点-通路-疾病”网络图分析发现,槲皮素、木犀草素、金雀异黄素、山柰酚、β-谷甾醇、非瑟酮、甘草素、8-异戊烯-山奈酚、花萼素、β-胡萝卜素作为芪胶升白胶囊的核心活性成分,可作用于PTGS2、RXRA、PIK3CG、CDK2、TNF、IL6、AKT1、CASP3、MAPK1、BCL2关键靶点,发挥治疗白细胞减少症的作用.临床研究发现,芪胶升白胶囊可明显升高住院期间白细胞减少症患者的白细胞水平,有效率达60.00%.动物实验发现,芪胶升白胶囊可明显升高小鼠白细胞水平(P<0.05),降低外周血TNF-α、IL-6水平(P<0.05).结果表明,芪胶升白胶囊中活性成分可作用于TNF-α、IL-6等关键靶点,参与免疫炎症等通路发挥治疗白细胞减少症的作用.

Hematological abnormalities in liver cirrhosis

Hematological abnormalities are common in cirrhosis and are associated with various pathophysiological mechanisms.Studies have documented a prevalence of thrombocytopenia,leukopenia,and anemia in patients with compensated cirrhosis of 77.9%,23.5%,and 21.1%,respectively.These abnormalities carry significant clinical implications,including considerations for invasive procedures,infection risk,bleeding risk,and prognosis.Previously,cirrhosis was believed to predispose patients to bleeding due to alterations observed in classical coagula-tion tests such as prothrombin time,partial thromboplastin time,international normalized ratio,and thrombocytopenia.However,this understanding has evol-ved,and cirrhosis patients are now also acknowledged as being at a high risk for thrombotic events.Hemostasis in cirrhosis patients presents a complex pheno-type,with procoagulant and anticoagulant abnormalities offsetting each other.This multifactorial phenomenon is inadequately reflected by routine laboratory tests.Thrombotic complications are more prevalent in decompensated cirrhosis and may correlate with disease severity.Bleeding is primarily associated with portal hypertension,endothelial dysfunction,mechanical vessel injury,dissem-inated intravascular coagulation,endotoxemia,and renal injury.This review comprehensively outlines hematologic index abnormalities,mechanisms of hemostasis,coagulation,and fibrinolysis abnormalities,limitations of laboratory testing,and clinical manifestations of bleeding and thrombosis in patients with liver cirrhosis.

白细胞减少的准广泛耐药肺结核患者使用康替唑胺的临床实践分析

目的:分析1例白细胞减少的准广泛耐药(pre-extensively drug-resistant,pre-XDR)肺结核患者使用康替唑胺的临床实践过程,为类似耐药结核病患者探索有效的抗结核治疗方案提供参考。方法与结果:患者4个月前被确诊为pre-XDR肺结核,并予贝达喹啉+利奈唑胺+氯法齐明+环丝氨酸+丙硫异烟胺抗结核治疗;治疗20 d后,反复出现头晕、多梦、易醒等症状;1 d前,再次出现难以入睡症状并伴烦热感和右膝关节疼痛,遂入院治疗;住院期间,患者多次出现白细胞减少情况,考虑为利奈唑胺骨髓抑制所致,服用利可君片亦不能改善,临床在斟酌后决定停用利奈唑胺,改用康替唑胺,之后白细胞水平果然明显恢复;此外,患者反复出现的难以入睡症状考虑为环丝氨酸的中枢神经毒性反应,而住院期间出现的Q-T间期延长则考虑是贝达喹啉所致,遂决定停用此二药;最后,患者的抗结核方案被调整为康替唑胺+氯法齐明+阿米卡星+乙胺丁醇+丙硫异烟胺,之后患者未再出现不适症状和指标异常。结论:pre-XDR肺结核属于较为难治的疾病,治疗时用药较多且复杂,很容易发生药物不良反应,并且部分药物不良反应可能会导致严重不良后果;对此,临床应采取积极干预措施,并及时调整抗结核治疗方案,以保证患者的用药安全和治疗效果。

芪胶升白胶囊治疗肺癌化疗引起的白细胞减少症的效果观察

目的:分析芪胶升白胶囊治疗肺癌化疗引起的白细胞减少症的效果。方法:选取2022年5月—2023年5月西安交通大学第二附属医院收治的肺癌化疗引起的白细胞减少症患者80例作为研究对象,按照随机数字表法分为对照组和观察组,各40例。对照组给予地榆升白片治疗,观察组给予芪胶升白胶囊治疗。比较两组治疗效果。结果:治疗1、8周后,两组白细胞计数逐渐升高,且治疗8周后观察组白细胞计数高于对照组(P<0.05)。治疗后,两组生活质量评分高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P=0.003)。观察组不良反应总发生率低于对照组,差异有统计学意义(P=0.034)。结论:芪胶升白胶囊治疗肺癌化疗引起的白细胞减少症的效果显著,可提高白细胞水平,改善生活质量,降低不良反应发生率。

扶正升白汤对小细胞肺癌化疗后白细胞减少症患者的影响

目的:探讨扶正升白汤对小细胞肺癌化疗后白细胞减少症患者白细胞计数、卡诺夫斯凯计分(KPS)的影响。方法:选取2020年1月至2021年3月河北中医药大学附属沧州中西医结合医院收治的需进行化疗的小细胞肺癌患者(化疗后白细胞减少)120例为研究对象,通过随机数字表法分为观察组(60例,皮下注射重组人粒细胞集落刺激因子+扶正升白汤)和对照组(60例,皮下注射重组人粒细胞集落刺激因子)。比较两组患者的临床疗效、中医证候积分、白细胞计数、中性粒细胞绝对值和KPS评分。结果:观察组患者的总有效率为88.33%(53/60),高于对照组的70.00%(42/60),差异有统计学意义(P<0.05)。与治疗前相比,两组患者治疗后中医证候积分降低,白细胞计数、中性粒细胞绝对值升高,KPS评分升高;且观察组患者治疗后上述指标优于对照组,差异均有统计学意义(P<0.05)。结论:扶正升白汤能显著提高小细胞肺癌化疗后白细胞减少症患者的白细胞计数,改善临床症状,提高KPS评分。

猫咬伤致新型布尼亚病毒感染患者的护理

总结1例猫咬伤导致新型布尼亚病毒感染的护理体会。护理要点:通过不典型伤口追溯感染源;建立白细胞危象预警机制;中医手法治疗顽固性呕吐;实施闭环感控管理;预防创伤后综合征。患者住院7 d出院,恢复良好。

NUDT15基因多态性与巯嘌呤类药物所致白细胞减少相关性的Meta分析

目的系统评价NUDT15基因多态性与巯嘌呤类药物所致白细胞减少的相关性。方法计算机检索中国知网、万方、维普、中国生物医学文献、PubMed、Embase数据库获取相关文献,检索时限从建库至2023年6月。采用纽卡斯尔-渥太华量表(Newcastle-Ottawa Quality Assessment Scale,NOS)对纳入文献进行质量评价,采用Stata 14.0软件进行Meta分析。结果最终纳入17篇文献,共4057例患者,其中1017例患者使用巯嘌呤类药物后产生不同程度的白细胞减少或中性粒细胞减少。Meta分析结果显示,在NUDT15基因多态性下,各分组整体效应均具有统计学意义(P<0.001):用药8周内所致白细胞减少情况中,等位基因模型[OR=0.15,95%CI(0.10,0.22),P<0.001]、显性基因模型[OR=0.13,95%CI(0.08,0.20),P<0.001]、杂合基因模型[OR=0.04,95%CI(0.01,0.19),P<0.001]与白细胞减少具有显著相关性;用药超过8周所致白细胞减少情况中,等位基因模型[OR=0.18,95%CI(0.11,0.30),P<0.001]、显性基因模型[OR=0.17,95%CI(0.09,0.31),P<0.001]、杂合基因模型[OR=0.05,95%CI(0.02,0.15),P<0.001]与白细胞减少具有显著相关性;3~4级严重白细胞减少情况中,显性基因模型[OR=0.09,95%CI(0.05,0.15),P<0.001]与白细胞减少具有显著相关性。结论NUDT15基因多态性与巯嘌呤类药物所致白细胞减少具有相关性。

Acupoint Injection plus Moxibustion on Post-chemotherapy Leukopenia

Objective： to investigate the effect moxibustion on white blood cell amount and of Radi.r Astragali （ 黄芪 ） Injection and cellular immunity in patients with postchemotherapy leukopenia. Methods： eighty-six cases of post chemotherpy leucopenia were allocated into group of acupoint injection with Radix Astragali （黄芪） plus mild moxibustion with moxa stick（treatment group） and group of westerm medicine orally took（control group）, and the clinical symptoms, white blood cell amount, and the change of CD3^＋ , CD4^＋ and CD8^＋ before and after the treatment were observed. Results. acupoint injection with Radicc Astragali（黄芪） plus mild moxibustion with moxa stick could enhance the white blood cell amount more markedly than western medicine. The former could increase the contents of CD3^＋ and CD2^＋, and promote the ratio of CD4^＋ /CD^＋ of the patients with tumor, meanwhile, improve the general weak, and there is a significant different between the two groups（P〈 0.01）.

首次诊断Graves病患者白细胞或中性粒细胞计数减少的相关因素分析

目的分析首次诊断Graves病患者外周血液中白细胞或中性粒细胞计数减少的相关因素。方法收集2020年3月~2022年11月在某院就诊的113例Graves病患者一般资料以及实验室检查,根据外周血液中白细胞或中性粒细胞计数是否减少,分为白细胞和中性粒细胞计数正常组(正常组)和白细胞或中性粒细胞计数减少组(减少组)。对首次诊断Graves病患者白细胞或中性粒细胞计数减少的相关因素进行分析。结果统计分析结果显示,两组患者年龄、性别、病程差异无统计学意义(P>0.05),减少组患者游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺激素受体抗体(TRAb)水平均高于正常组,差异有统计学意义(P<0.05),两组患者促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)水平差异无统计学意义(P>0.05)。相关分析显示,FT_(3)、FT_(4)、TRAb水平与白细胞或中性粒细胞计数减少呈正相关(P<0.05)。Logistic回归分析显示,高水平TRAb(OR=1.071,95%CI:1.00~1.15)与首次诊断Graves病患者外周血液中白细胞或中性粒细胞计数减少相关。结论首次诊断Graves病患者外周血液中白细胞或中性粒细胞计数减少与FT_(3)、FT_(4)、TRAb水平相关,高水平TRAb是其危险因素。

Observations on Curative Effect of Point Injection on Postchemotherapeutic Leukopenia

Objective： To investigate the effect of point injection on post-chemotherapeutic leukopenia. Methods： Three hundred patients were randomly divided into two groups. In the treatment group, 0.6 ml granulocyte colony stimulating factor was injected into bilateral Xuehai （SP 10） and in the control group, the same dose subcutaneously into the deltoid muscle in the upper arm, once daily, three consecutive times as a course of treatment. A peripheral leukocyte count was examined at 3rd, 5th and 7th day after injection. Results and Conclusion： Under three courses of chemotherapy, therewas no significant difference in leukocyte increase between the two methods at 3rd and 5th day after treatment but a leukocyte count was significantly higher at 7th day in the treatment group than in the control group （P〈0.05）. After over half courses of chemotherapy, a peripheral leukocyte count was significantly higher in the treatment group than in the control group （P〈0.05） and it did not rise to the normal at 5-7 days after treatment in the control group. It is showed that point injection raised leukocyte quickly and kept the effect long in comparison with subcutaneous injection and the adverse responses were significantly less in the treatment group than in the control group.

万古霉素致白细胞及中性粒细胞减少症的药学监护

目的:报道并分析1例患者使用万古霉素后出现的白细胞及中性粒细胞减少不良反应,为临床合理安全使用提供参考。方法:对临床药师参与老年患者先天性左髋关节发育不良术后刀口感染应用万古霉素后导致白细胞及中性粒细胞减少的案例进行分析,根据Naranjo评估量表并结合文献资料,评估该不良反应与万古霉素间的关系及处理措施。结果:出现白细胞及中性粒细胞减少,临床药师建议停用万古霉素。患者停用4天后白细胞及中性粒细胞恢复至正常水平。根据Naranjo评估量表得分为5分,评价关系为“很可能”有关。结论:临床药师参与临床治疗用药的全过程,可帮助临床医生识别药物不良反应,警示临床医生关注患者使用万古霉素过程中引起的白细胞及中性粒细胞减少,保障患者用药安全性和有效性。