马来酸桂哌齐特致急性粒细胞缺乏症  

Acute agranulocytosis caused by cinepazide maleate

作　　者：毛敏[1] 邵明晶[2] 贾海忠[2] 黄力[2] 陆进[1] 

机构地区：[1]中日友好医院药学部临床药学室,北京100029 [2]中日友好医院中西医结合心脏内科,北京100029

出　　处：《药物不良反应杂志》2014年第6期370-371,共2页Adverse Drug Reactions Journal

摘　　要：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。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.

关 键 词：桂哌齐特 粒细胞缺乏 

分 类 号：R969[医药卫生—药理学]