摘要
1例65岁男性患者,1个月前诊断为甲状腺功能亢进症,规律服用甲巯咪唑20 mg·d^(-1)治疗。期间无规律复查血常规。4 d前患者出现发热、咳嗽、咽痛等症状,未诊治。上述症状反复,复查血常规示:白细胞1.76×109·L^(-1),中性粒细胞0.01×10~9·L^(-1),伴发热,诊断为"粒细胞缺乏症"。遂停用甲巯咪唑,保护性隔离,并给予"重组人粒细胞刺激因子、地榆升白片"升高白细胞,同时积极给予经验性抗感染治疗。期间患者反复出现高热、咽痛、腹泻等症状,监测血常规提示连续1周粒细胞为零,根据病情调整重组人粒细胞刺激因子剂量,根据病原学结果调整抗感染治疗方案,治疗13 d后,患者白细胞及中性粒细胞逐渐升至正常范围,病情稳定。
One 65-year-old male patient was diagnosed with hyperthyroidism a month ago.The patient was regularly treated with methimazole 20 mg·d^-1.While,blood routine examination was rechecked irregularly during the treatment.Four days ago,the patient had fever,cough,sore throat and other symptoms,with no diagnosis and treatment.The symptoms above repeatedly manifested.Blood routine examination showed that white blood cell count was 1.76 × 10^9·L^-1,neutrophils count was 0.01 × 10^9·L^-1,which was diagnosed with agranulocytosis.Then methimazole was stopped.The protective isolation,recombinant human G-CSF and Diyushengbai tablets for increasing white blood cell count were used.As well as anti-infective therapy were also given.During the period,high fever,sore throat,diarrhea and other symptoms occurred frequently.Blood routine examination showed that the neutrophils count was zero for a week.Then according to the patient＇s condition,the dosage of recombinant human G-CSF was adjusted,and the anti-infective treatment regimen was adjusted according to the results of pathogens.White blood cell count and neutrophils count recovered to normal range after the 13-day treatment.The condition of patient was stable.
出处
《中国药物应用与监测》
CAS
2017年第5期324-326,共3页
Chinese Journal of Drug Application and Monitoring
基金
广东省科技计划项目(20130319c)
