作者报告1例38岁酒精中毒性肝硬化及胃溃疡出血的男性患者,在用甲氰咪胍治疗时出现粒细胞减少,停药后又见其回升。用此药时,血小板亦见降低,骨髓象则显示巨核细胞减少。患者经确诊为酒精中毒性肝硬化后,因疑有胃肠出血而入院治疗。8个月前曾因肝功能失代偿住院治疗,当时因有食管静脉曲张破裂出血的危险,曾用甲氰咪胍,每日5次,每次200mg。其它药物治疗尚有安体舒通,每日4次,每次50mg 及 Vit B_∞等。4天后患者出现逐渐加重的精神错乱而无明显脑电图政变,无胃肠出血指征和血氨水平改变,故停用甲氰咪胍。在患者症状改善后复用甲氰咪胍达2个月以上,无任何副作用产生。本次用药静注治疗,10天内白细胞数由11.9×10~9/L降至2.9×10~9/L,即将甲氰咪胍改为口服,每日5次,每次200mg,嗣后的10天中白细胞数继续降至 The authors report a male patient with 38-year-old alcoholic cirrhosis and gastric ulcer bleeding who developed neutropenia after treatment with cimetidine and recovered after withdrawal. With this drug, platelets also see reduced bone marrow showed megakaryocyte reduction. Patients diagnosed with alcoholic cirrhosis, admitted to hospital for suspected gastrointestinal bleeding. He was hospitalized eight months ago for decompensated liver function. Cimetidine was used five times a day for 200 mg at a time because of the risk of bleeding from esophageal varices. There are other drug therapy spironolactone, 4 times a day, each 50mg and Vit B_∞ and so on. Four days later, patients gradually aggravated mental disorders without obvious EEG coup, no signs of gastrointestinal bleeding and changes in blood ammonia levels, so the withdrawal of cimetidine. Cimetidine is more than 2 months after the improvement of symptoms in patients without any side effects. The intravenous drug treatment, 10 days the white blood cell count decreased from 11.9 × 10 ~ 9 / L to 2.9 × 10 ~ 9 / L, about to cimetidine into oral, 5 times a day, each 200mg, followed by 10 The number of white blood cells in the day continued to drop