Fukata S, Kuma K, Sugawara M
Kuma Hospital, Kobe, Japan.
Thyroid. 1999 Jan;9(1):29-31. doi: 10.1089/thy.1999.9.29.
Agranulocytosis is the most serious side effect of antithyroid drug (ATD) therapy. We conducted prospective and randomized studies to examine whether granulocyte colony-stimulating factor (G-CSF) is actually effective for ATD-induced agranulocytosis. Twenty-four patients with Graves' disease who developed agranulocytosis during ATD therapy were randomly divided into a G-CSF group (n = 14) and an untreated group (n = 10). Subcutaneous injection of G-CSF (100 to 250 microg) was given daily until neutrophil counts rose to greater than 1000/microL. The untreated group received antibiotic therapy only. Recovery time, which is defined as the number of days required for neutrophil counts to exceed 500/microL, was monitored by daily complete blood count (CBC). Recovery time in the G-CSF-treated group did not differ from that of the untreated group in those patients with moderate and severe agranulocytosis; thus, prolonged use of G-CSF treatment is generally ineffective for ATD-induced agranulocytosis.
粒细胞缺乏症是抗甲状腺药物（ATD）治疗最严重的副作用。我们进行了前瞻性随机研究，以检验粒细胞集落刺激因子（G-CSF）对ATD引起的粒细胞缺乏症是否确实有效。24例在ATD治疗期间发生粒细胞缺乏症的格雷夫斯病患者被随机分为G-CSF组（n = 14）和未治疗组（n = 10）。每天皮下注射G-CSF（100至250微克），直至中性粒细胞计数升至大于1000/微升。未治疗组仅接受抗生素治疗。通过每日全血细胞计数（CBC）监测恢复时间，恢复时间定义为中性粒细胞计数超过500/微升所需的天数。在中度和重度粒细胞缺乏症患者中，G-CSF治疗组的恢复时间与未治疗组无差异；因此，长期使用G-CSF治疗对ATD引起的粒细胞缺乏症通常无效。
