目的 分析一组临床常用药物致白细胞减少和粒细胞缺乏的临床表现,提高对药物所致血液系统损害的认识,促进合理用药,提高临床用药安全性.方法 收集1990年1月至2010年12月经我院血液科诊治的66例药物性白细胞减少和粒细胞缺乏患者的临床资料进行回顾性分析.结果 66例药物性白细胞减少和粒细胞缺乏患者中,抗甲状腺功能亢进药所致者16例,占24.2％,抗菌药物9例,占13.6％；抗精神病药物9例,占13.6％；抗癫痫病药物9例,占13.6％；抗类风湿性关节炎药物6例,占9.1％；抗痛风药物4例,占6.1％；降糖药物3例,占4.5％；治疗系统性红斑狼疮皮肤损害的药物3例,占4.5％；治疗胃、十二指肠球部溃疡的药物2例,占3.0％；解热镇痛药物2例,占3.0％；预防乳腺癌根治术后复发的抗雌激素药物2例,占3.0％；口腔科治疗牙痛的中成药制剂1例,占1.5％.临床表现有:白细胞下降(54例,81.8％),粒细胞缺乏(12例,18.2％),骨髓造血功能停滞(3例,4.5％),高热(23例,34.8％),皮肤损害(10例,15.1％),继发各种感染(58例,89％),重症感染(10例,15.1％),感染性休克(3例,4.5％),真菌性败血症(2例,3％),肝功能衰竭(1例,1.5％),肾功能衰竭(1例,1.5％),死亡(3例,4.5％).结论 临床部分常用药物可致白细胞减少、粒细胞缺乏而继发各种感染,可导致病情急剧变化,甚至危及生命,所以要高度重视药物使用的安全性.
目的 分析一組臨床常用藥物緻白細胞減少和粒細胞缺乏的臨床錶現,提高對藥物所緻血液繫統損害的認識,促進閤理用藥,提高臨床用藥安全性.方法 收集1990年1月至2010年12月經我院血液科診治的66例藥物性白細胞減少和粒細胞缺乏患者的臨床資料進行迴顧性分析.結果 66例藥物性白細胞減少和粒細胞缺乏患者中,抗甲狀腺功能亢進藥所緻者16例,佔24.2％,抗菌藥物9例,佔13.6％；抗精神病藥物9例,佔13.6％；抗癲癇病藥物9例,佔13.6％；抗類風濕性關節炎藥物6例,佔9.1％；抗痛風藥物4例,佔6.1％；降糖藥物3例,佔4.5％；治療繫統性紅斑狼瘡皮膚損害的藥物3例,佔4.5％；治療胃、十二指腸毬部潰瘍的藥物2例,佔3.0％；解熱鎮痛藥物2例,佔3.0％；預防乳腺癌根治術後複髮的抗雌激素藥物2例,佔3.0％；口腔科治療牙痛的中成藥製劑1例,佔1.5％.臨床錶現有:白細胞下降(54例,81.8％),粒細胞缺乏(12例,18.2％),骨髓造血功能停滯(3例,4.5％),高熱(23例,34.8％),皮膚損害(10例,15.1％),繼髮各種感染(58例,89％),重癥感染(10例,15.1％),感染性休剋(3例,4.5％),真菌性敗血癥(2例,3％),肝功能衰竭(1例,1.5％),腎功能衰竭(1例,1.5％),死亡(3例,4.5％).結論 臨床部分常用藥物可緻白細胞減少、粒細胞缺乏而繼髮各種感染,可導緻病情急劇變化,甚至危及生命,所以要高度重視藥物使用的安全性.
목적 분석일조림상상용약물치백세포감소화립세포결핍적림상표현,제고대약물소치혈액계통손해적인식,촉진합리용약,제고림상용약안전성.방법 수집1990년1월지2010년12월경아원혈액과진치적66례약물성백세포감소화립세포결핍환자적림상자료진행회고성분석.결과 66례약물성백세포감소화립세포결핍환자중,항갑상선공능항진약소치자16례,점24.2％,항균약물9례,점13.6％；항정신병약물9례,점13.6％；항전간병약물9례,점13.6％；항류풍습성관절염약물6례,점9.1％；항통풍약물4례,점6.1％；강당약물3례,점4.5％；치료계통성홍반랑창피부손해적약물3례,점4.5％；치료위、십이지장구부궤양적약물2례,점3.0％；해열진통약물2례,점3.0％；예방유선암근치술후복발적항자격소약물2례,점3.0％；구강과치료아통적중성약제제1례,점1.5％.림상표현유:백세포하강(54례,81.8％),립세포결핍(12례,18.2％),골수조혈공능정체(3례,4.5％),고열(23례,34.8％),피부손해(10례,15.1％),계발각충감염(58례,89％),중증감염(10례,15.1％),감염성휴극(3례,4.5％),진균성패혈증(2례,3％),간공능쇠갈(1례,1.5％),신공능쇠갈(1례,1.5％),사망(3례,4.5％).결론 림상부분상용약물가치백세포감소、립세포결핍이계발각충감염,가도치병정급극변화,심지위급생명,소이요고도중시약물사용적안전성.
Objective By describing the clinical manifestation of a group of commonly used medicines causing pharmacologic leukopenia and agranulocytosis,obtain a better understanding of damage to the blood system by medicines,call attention to rational medication and increase the pharmic safety.Methods Retrospectively analyze the clinical data of the 66 patients of the Department of Hematology in my working hospital from January 1990 to December 2010.Results Among the 66 patients,ADR of 16(24.2％ ) were caused by thyroid function of hyperthyroidism medicine,9( 13.6％ ) by antibacterial drugs,9( 13.6％ ) by antipsychotic drugs,9( 13.6％ ) by antiepileptic drugs,6(9.1％ ) by anti-rheumatoid arthritis drugs,4(6.1％ ) by drugs treating gout,3(4.5％ ) by glucoselowering drugs,3(4.5％ ) by drugs treating systemic lupus erythematosus skin damage,2(3％ ) by drugs treating stomach,duodenum ball department ulcer,2 (3 ％ ) by antipyretic analgesics,2 (3％) by anti-estrogen drugs used to prevent recurrence after mastectomy,1 (1.5％) by proprietary Chinese medicine preparation treating toothache.The clinical manifestation showed white blood cells decreased (54 cases,81.8％ ),agranulocytosis (12 cases,18.2％ ),bone marrow hematopoietic function stagnation(3 cases,4.5％ ),high fever(23 cases,34.8％ ),skin damage( 10 cases,15.1％ ),various secondary infections(58 cases,89％ ),agonal infections( 10 cases,15.1％ ),septic shock ( 3 cases,4.5 ％ ),fungal sepsis (2 cases,3 ％ ),liver failure ( 1 case,1.5 ％ ),renal failure ( 1 case,1.5％ ),and 3deaths(4.5％ ).Conclusion We should think much of the pharmic safety owing to the fact that some commonly used medicines can cause slow or sharp decrease of white blood cells or agranulocytosis and various infections follow.Those can lead to sharp change in the patients' conditions or even take their lives.
