CAJ | 학술논문

1例82岁男性患者，因脑梗死静脉滴注马来酸桂哌齐特（320 mg 入0.9%氯化钠注射液，1次/ d），连续31 d。用药前中性粒细胞计数（NEUT）为5.7×109/ L；用药28 d 时 NEUT 为2.4×109/ L。间隔5 d 后再次原剂量用药。再次用药第6天患者 NEUT 降至0.2×109/ L。停用马来酸桂哌齐特，给予甲钴胺（500μg、2次/ d）、叶酸（5 mg、1次/ d）和利可君（20 mg、2次/ d）口服。2 d 后NEUT 降至0。给予重组人粒细胞刺激因子200μg 皮下注射，2次/ d。2 d 后，NEUT 回升至4.5×109/ L。因患者合并多种疾病，应用马来酸桂哌齐特时合并用药多达15种。随访18个月，患者未再应用马来酸桂哌齐特，其他合并用药则多数继续应用，未再出现中性粒细胞减少。考虑急性粒细胞缺乏症为马来酸桂哌齐特所致。
1례82세남성환자，인뇌경사정맥적주마래산계고제특（320 mg 입0.9%록화납주사액，1차/ d），련속31 d。용약전중성립세포계수（NEUT）위5.7×109/ L；용약28 d 시 NEUT 위2.4×109/ L。간격5 d 후재차원제량용약。재차용약제6천환자 NEUT 강지0.2×109/ L。정용마래산계고제특，급여갑고알（500μg、2차/ d）、협산（5 mg、1차/ d）화리가군（20 mg、2차/ d）구복。2 d 후NEUT 강지0。급여중조인립세포자격인자200μg 피하주사，2차/ d。2 d 후，NEUT 회승지4.5×109/ L。인환자합병다충질병，응용마래산계고제특시합병용약다체15충。수방18개월，환자미재응용마래산계고제특，기타합병용약칙다수계속응용，미재출현중성립세포감소。고필급성립세포결핍증위마래산계고제특소치。
An 82-year-old male patient with cerebral infarction received an IV infusion of cinepazide maleate 320 mg + 0. 9% sodium chloride injection once daily for 30 consecutive days. The patient' s neutrophil count(NEUT)was 5. 7 × 109 / L before treatments and 2. 4 × 109 / L on day 28 of treatments. An interval of 5 days later,cinepazide maleate was given again at the same dosage. On day 6 of second use of cinepazide maleate,the patient's NEUT decreased to 0. 2 × 109 / L. Cinepazide maleate was stopped and mecobalamin(500 μg,twice daily),folic acid(5 mg,once daily),and leucogen(20 mg,twice daily) were given. Two days later,the patient's NEUT decreased to 0. Recombinant human granulocyte colony stimulating factor 200 μg twice daily was injected subcutaneously. Two days later,the patient' s NEUT increased to 4. 5 × 109 / L. The patient received cinepazide maleate combined with 15 kinds of drugs at the same time because he suffered from several kinds of diseases. During 18 months of follow-up,the patient did not take cinepazide maleate again and most other combination drugs were used continuously and neutropenia did not recur. It was considered that cinepazide maleate induced the patient's acute agranulocytosis.