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目的了解丙基硫氧嘧啶(PTU)致粒细胞减少症的发病情况、临床表现及治疗对策。方法对近2年门诊有完整记录的64例PTU致粒细胞减少症的临床特征及治疗情况进行统计分析。结果粒细胞减少症多数发生在服药后2～8周,且与PTU的剂量有关。多数病例有头昏、乏力的临床症状。全部病例继续使用PTU,加用口服升白药或皮下注射粒细胞集落刺激因子(G-CSF),粒细胞均恢复正常,无1例发生粒细胞缺乏症。结论PTU起始剂量不宜超过300mg/d,使用头1、2个月内应密切观察外周血白细胞计数,口服升白药或注射G-CSF对白细胞恢复是有效的,并可避免粒细胞缺乏症的发生。
Objective To investigate the incidence, clinical manifestation and treatment of propylthiouracil (PTU) neutrophil granulocytopenia. Methods The clinical features and treatment of 64 cases of PTU neutropenia with complete records in the past two years were statistically analyzed. Results Most of the neutropenia occurred 2 to 8 weeks after taking the medicine, and was related to the dose of PTU. Most cases have dizziness, fatigue, clinical symptoms. All cases continue to use PTU, plus oral whitening agent or subcutaneous injection of granulocyte colony stimulating factor (G-CSF), granulocytes were returned to normal, no case of agranulocytosis. Conclusion The starting dose of PTU should not exceed 300mg / d, the first and second months should be closely observed peripheral blood leukocyte count, oral administration of Baiyin or G-CSF injection of leukocyte recovery is effective and can prevent the occurrence of agranulocytosis .