甲氧苄啶-磺胺甲恶唑对巨幼细胞造血患者的毒性
Toxicity of trimethoprim-sulphamethoxazole in patients with megaloblastic haemopoiesis.
作者信息
Chanarin I, England J M
出版信息
Br Med J. 1972 Mar 11;1(5801):651-3. doi: 10.1136/bmj.1.5801.651.
Abstract
Four consecutive patients with megaloblastic anaemia who also received therapy with trimethoprim-sulphamethoxazole all showed poor responses to specific haematinic therapy. This was attributed to trimethoprim, which suppressed reticulocyte responses in three cases and produced a pancytopenia in two and a falling haemoglobin with neutropenia in a third. A fourth patient, with pernicious anaemia, had a satisfactory reticulocyte response but experienced no clinical benefit until after withdrawal of trimethoprim.Trimethoprim seems not to be a safe form of therapy in patients with a megaloblastic process; many of the toxic reactions reported with this drug may be on the basis of an unrecognized megaloblastic form of haemopoiesis.
摘要
连续四位患有巨幼细胞贫血且接受了甲氧苄啶 - 磺胺甲恶唑治疗的患者，对特定的造血素治疗均反应不佳。这归因于甲氧苄啶，它在三例患者中抑制了网织红细胞反应，在两例患者中导致全血细胞减少，在第三例患者中导致血红蛋白下降伴中性粒细胞减少。第四例患有恶性贫血的患者，网织红细胞反应令人满意，但直到停用甲氧苄啶后才获得临床益处。甲氧苄啶似乎并非巨幼细胞病变患者的安全治疗方式；该药物报道的许多毒性反应可能基于未被识别的巨幼细胞造血形式。
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