Shaunak S, Bartlett J A
Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina 27710.
Lancet. 1989 Jul 8;2(8654):91-2. doi: 10.1016/s0140-6736(89)90325-5.
30 patients with recurrent zidovudine-induced neutropenia were followed up for a total of 493 months of treatment to evaluate their risk of bacterial infection. Zidovudine was temporarily discontinued only when the polymorphonuclear (PMN) cell count fell to less than 500/microliters. The incidence of bacterial infection during periods of severe neutropenia (PMN less than 500/microliters) was 230% higher than when the PMN count was 500-1000/microliters, and 600% higher than when the count was greater than 1000/microliters. The difference between periods when the PMU count was 500-1000/microliters and non-neutropenic periods was not significant. The findings suggest that zidovudine therapy can be continued despite neutropenia without a major increase in the incidence of bacterial infection provided the PMN count does not fall to less than 500/microliters.
对30例齐多夫定诱导的复发性中性粒细胞减少症患者进行了总计493个月的治疗随访，以评估他们发生细菌感染的风险。仅当多形核（PMN）细胞计数降至低于500/微升时才暂时停用齐多夫定。严重中性粒细胞减少症（PMN低于500/微升）期间细菌感染的发生率比PMN计数为500 - 1000/微升时高230%，比计数大于1000/微升时高600%。PMN计数为500 - 1000/微升的时期与非中性粒细胞减少症时期之间的差异不显著。研究结果表明，只要PMN计数不降至低于500/微升，即使存在中性粒细胞减少症，齐多夫定治疗仍可继续，且细菌感染的发生率不会大幅增加。
