粒细胞缺乏症的临床特点及实验室检查

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目的:探讨粒细胞缺乏症(粒缺)的临床及实验室检查特点。方法:对我院10年内收治的67例粒缺住院患者,回顾分析其临床资料、外周血常规、骨髓象及病原学检查的结果。结果:67例中,以药物性的粒缺和感染性粒缺为主,分别为41例(61.2%)和16例(23.9%)。白细胞计数为(0.36~1.79)×109/L,骨髓增生程度从减低到明显活跃;病原学检查26例,其中血培养10例,阳性率20.0%;咽拭子培养16例,阳性率12.5%;粒缺治疗中除了抗感染、并发症的对症处理、加强环境保护及规范化护理外,57例患者使用了粒细胞集落刺激因子(G-CSF),10例使用利血生、强力升白片、鲨肝醇等治疗。治愈19例、好转45例、自动出院2例、死亡1例。结论:药物和感染可能是导致粒细胞缺乏症的直接诱因,同时加强病原学检查有助于粒细胞缺乏症的治疗。 Objective: To investigate the clinical and laboratory features of agranulocytosis (granuloma). Methods: A total of 67 patients with granulomatous inpatient admitted to our hospital within 10 years were retrospectively analyzed. The clinical data, peripheral blood, bone marrow and etiological examination were retrospectively analyzed. Results: Among the 67 cases, drug-induced neutropenia and infectious neutropenia were the main symptoms, which were 41 cases (61.2%) and 16 cases (23.9%). The white blood cell count was (0.36-1.79) × 109 / L, and the degree of myeloproliferation decreased from obvious to active. Etiological examination was performed in 26 cases, of which 10 were blood culture. The positive rate was 20.0%. Throat swab culture was performed in 16 cases with a positive rate of 12.5% In addition to anti-infective and complications-symptomatic treatment of granulomatosis, 57 cases were treated with granulocyte-colony stimulating factor (G-CSF), 10 cases were treated with reserpine and strong lightening tablets , Shark liver alcohol treatment. 19 cases were cured, 45 cases improved, 2 cases were discharged automatically and 1 case died. CONCLUSIONS: Drugs and infections may be the direct cause of agranulocytosis, and enhanced etiological testing can help treat agranulocytosis.
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