Kao T W, Hung C C, Chen Y C, Tien H F
Department of Internal Medicine, National Taiwan University Hospital, Taipei, ROC.
Acta Haematol. 1997;98(4):211-3. doi: 10.1159/000203626.
In this study, three Chinese patients with ticlopidine-induced aplastic anemia were reported and another 13 patients in the English literature were reviewed. We attempted to find underlying similarities, evaluate the risk factors, and identify appropriate treatment for this complication. All but one of the patients were over 60 years old, and the 6 who died were all older than 65. Therefore, old age may be a risk factor for developing this complication. Agranulocytosis occurred 3-20 weeks after initiation of ticlopidine, so frequent examination of white cell count during treatment is recommended. There seemed to be no direct correlation between the dose or duration used and the severity of bone marrow suppression. Treatment for ticlopidine-induced aplastic anemia with colony-stimulating factors seemed to have little effect. The fact that 5 of the 6 patients who received concurrent calcium channel blockers died, should alert clinicians to be more cautious when using these two drugs simultaneously.
在本研究中，报告了3例服用噻氯匹定后发生再生障碍性贫血的中国患者，并对英文文献中的另外13例患者进行了回顾。我们试图找出潜在的相似之处，评估危险因素，并确定针对该并发症的适当治疗方法。除1例患者外，所有患者年龄均超过60岁，死亡的6例患者均超过65岁。因此，老年可能是发生该并发症的一个危险因素。粒细胞缺乏症在噻氯匹定开始使用后3至20周出现，因此建议在治疗期间频繁检查白细胞计数。所用剂量或疗程与骨髓抑制的严重程度之间似乎没有直接关联。用集落刺激因子治疗噻氯匹定引起的再生障碍性贫血似乎效果不佳。6例同时接受钙通道阻滞剂治疗的患者中有5例死亡，这一事实应提醒临床医生在同时使用这两种药物时要更加谨慎。
