摘要:
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1 例66 a 类风湿关节炎女性患者在使用来氟米特(20 mg,qd,po)联合甲氨蝶呤(7. 5 mg,qw,po)治疗1 个月后出现口唇 溃疡,血常规示三系明显降低。立即住院治疗。住院期间血象继续降低,达粒细胞缺乏症、严重血小板减少症及重度贫血水平;并出现腹痛,莫非氏征阳性。患者加用来氟米特与甲氨蝶呤治疗前血常规基本正常,但有慢性胆囊炎病史,因此考虑来氟米特与甲氨蝶呤合用致严重骨髓抑制伴机会性感染即慢性胆囊炎急性发作。予停用来氟米特与甲氨蝶呤。同时输注浓缩红细胞、机采血小板、使用重组人粒细胞集落刺激因子升白、抗感染等对症治疗。患者血细胞逐渐回升、胆囊炎得到控制,病情 趋于稳定。
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基金项目:
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广东省临床用药研究基金(长征-欣凯风湿免疫专项)(2015FS12)
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作者简介:
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曲彩红,副主任药师,Tel:020-85253221,E-mail:zssyqch@126. com |
通讯作者: |
参考文献:
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