论文部分内容阅读
1例53岁女性类风湿关节炎患者服用醋酸泼尼松,双氯芬酸钠、雷公藤多苷和来氟米特治疗。之后,因病情控制不佳,柳氮磺吡啶加入其治疗方案,柳氮磺吡啶的剂量初始为0.25 g,2次/d,1周后为0.25 g,3次/d,4周后为1.0 g,2次/d。柳氮磺吡啶治疗6周后患者白细胞和中性粒细胞计数分别由6.5×109/L和4.56×109/L降至1.6×109/L和0.45×109/L。立即停用柳氮磺吡啶、双氯芬酸钠、来氟米特及雷公藤多苷、并给予细胞集落因子、亚胺培南及氟康唑。患者白细胞和中性粒细胞计数在停用柳氮磺吡啶后1周和2周分别为5.5×109/L和2.86×109/L及6.4×109/L和2.53×109/L。之后,双氯芬酸钠,雷公藤多苷、来氟米特相继应用,白细胞和中性粒细胞计数均在正常范围内。
A 53-year-old woman with rheumatoid arthritis was treated with prednisone acetate, diclofenac sodium, tripterygium glycosides, and leflunomide. Later, due to poor disease control, sulfasalazine added to its treatment regimen, the initial dose of sulfasalazine 0.25 g, 2 times / d, 1 week after the 0.25 g, 3 times / d, 4 weeks after the 1.0 g, 2 times / d. Six weeks after sulfasalazine treatment, the white blood cell count and neutrophil count decreased from 6.5 × 109 / L and 4.56 × 109 / L to 1.6 × 109 / L and 0.45 × 109 / L, respectively. Sulfasalazine, diclofenac sodium, leflunomide, and tripterygium glycosides were discontinued immediately and were given cell colony factor, imipenem and fluconazole. Patients’ white blood cell and neutrophil counts were 5.5 × 109 / L and 2.86 × 109 / L at week 1 and week 2, and 6.4 × 109 / L and 2.53 × 109 / L respectively after sulfasalazine withdrawal. After diclofenac sodium, tripterygium glycosides, leflunomide were used in succession, white blood cell and neutrophil count were within the normal range.