新青霉素Ⅱ、庆大霉素引起粒细胞缺乏症

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一例金黄色葡萄球菌性心内膜炎及败血症肺栓塞的44岁女性患者,入院时血红蛋白13.4克,血小板430,000,白细胞15,700,分叶核83%,杆状核4%。以新青霉素Ⅲ12克/天静注19天后,白细胞下降至1,100,全部为淋巴细胞,血红蛋白8克%,但红细胞大小及染色正常。骨髓象显示细胞过多,有许多多核巨细胞。未见成熟阶段超过中幼粒的粒细胞。改用万古霉素5天(入院后24天),外周血象仍无粒细胞系。翌日,开始静注地塞米松10毫克/天,用后第3天,外周血象即可见粒细胞系,骨髓象亦出现比较成熟的粒细胞。另一例为葡萄球菌性心内膜炎的24岁男性患者,入院时白细胞15,400。以新青霉素Ⅲ18克/天治疗,第4天白细胞数降至9,000,减量至12克/天。在第 One 44-year-old female patient with staphylococcal endocarditis and septicemia received 13,4 g of hemoglobin on admission, 430,000 platelets, 15,700 leukocytes, 83% of leaf lobes, and 4% of rod nuclei. To new penicillin Ⅲ 12 g / day after intravenous injection of 19 days, the white blood cells dropped to 1,100, all lymphocytes, hemoglobin 8 g%, but the size and staining of normal red blood cells. Bone marrow shows too many cells, there are many multinucleated giant cells. No mature stage than the promyelocytic granulocytes. Use vancomycin for 5 days (24 days after admission), peripheral blood is still no granulocyte line. The next day, intravenous dexamethasone started 10 mg / day, with the first 3 days after the peripheral blood as visible granulocytes, bone marrow also appeared more mature granulocytes. Another case was a 24-year-old male with staphylococcal endocarditis, with 15,400 leukocytes on admission. With penicillin III18g / day treatment, white blood cell count dropped to 9,000 on the 4th day, reduced to 12 g / day. In the first
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