Blaser Lea, Hassna Hala, Hofmann Sarah, Holbro Andreas, Haschke Manuel, Rätz Bravo Alexandra, Zeller Andreas, Krähenbühl Stephan, Taegtmeyer Anne
Division of Clinical Pharmacology and Toxicology, University and University Hospital Basel, Switzerland.
Division of Haematology, University Hospital Basel, Switzerland.
Swiss Med Wkly. 2017 May 24;147:w14438. doi: 10.4414/smw.2017.14438. eCollection 2017.
The aim of this study was to identify possible risk factors for the development of leucopenia associated with metamizole use.
A retrospective case-control study was performed. Cases of metamizole-associated leucopenia managed at a single centre (2005-2013) were characterised and compared with matched controls who took metamizole without developing complications.
Fifty-seven cases and 139 controls were identified. Of the cases, 32 were postoperative and these were compared to age-, sex- and ward-matched postoperative controls (n = 64). The remaining cases (n = 25) were compared to sex-matched, non-postoperative controls (n = 75). The number of patients with a positive allergy history was higher among postoperative cases than controls (p = 0.004) as was the number with previous leucopenic episodes (p = 0.03). The prevalence of diagnosed hepatitis C infection was 9% among all cases compared with 1% among all controls (p = 0.005). The use of concomitant cytostatic agents (even at immunosuppressive doses) was significantly higher among non-postoperative cases than controls (p = 0.011). There was no association between renal function and the development of leucopenia.
A history of allergies, previous leucopenic episodes, hepatitis C infection and concomitant cytostatic agents are possible risk factors for leucopenia associated with metamizole use.
本研究旨在确定与使用安乃近相关的白细胞减少症发生的可能危险因素。
进行了一项回顾性病例对照研究。对在单个中心（2005 - 2013年）接受治疗的安乃近相关性白细胞减少症病例进行特征分析，并与使用安乃近但未出现并发症的匹配对照进行比较。
共确定了57例病例和139例对照。其中32例病例为术后患者，将其与年龄、性别和病房匹配的术后对照（n = 64）进行比较。其余病例（n = 25）与性别匹配的非术后对照（n = 75）进行比较。术后病例中有过敏史阳性的患者数量高于对照（p = 0.004），既往有白细胞减少发作史的患者数量也是如此（p = 0.03）。所有病例中丙型肝炎感染的诊断患病率为9%，而所有对照中为1%（p = 0.005）。非术后病例中同时使用细胞毒性药物（即使是免疫抑制剂量）的比例显著高于对照（p = 0.011）。肾功能与白细胞减少症的发生之间没有关联。
过敏史、既往白细胞减少发作史、丙型肝炎感染以及同时使用细胞毒性药物可能是与使用安乃近相关的白细胞减少症的危险因素。
