硫唑嘌呤联合美沙拉嗪治疗炎症性肠病致急性骨髓抑制一例报道并文献回顾

doi:10.12114/j.issn.1007-9572.2019.00.058

摘要/Abstract

摘要： 硫唑嘌呤（AZA）是一种通过抑制淋巴细胞增殖产生免疫抑制作用的免疫抑制剂，能用于治疗炎症性肠病（IBD），但不良反应发生率高。本文对2017-12-12广东中医药大学第二临床医学院消化内科成功救治的1例口服AZA 18个月后联合应用美沙拉嗪2个月出现急性骨髓抑制的IBD患者的血常规进行分析，并查阅文献发现国内AZA联合美沙拉嗪致骨髓抑制的病例报道较少见，但国外报道较丰富，通过梳理国内外相关文献指出IBD联合用药存在的问题，以期提高临床对IBD诊疗的认识及重视。

关键词: 炎性肠疾病；硫唑嘌呤；美沙拉嗪；药物疗法, 联合；骨髓抑制；病例报告；文献复习

Abstract: Azathioprine（AZA） is an immunosuppressant that inhibits lymphocyte proliferation and could be used for inflammatory bowel disease（IBD），but has a high incidence of adverse reactions.We reported a case of IBD in December 12，2017 in Gastroenterology Department of Guangzhou University of Chinese Medicine who had acute myelosuppression after being treated with oral AZA for 18 months，then AZA with mesalazine for 2 months，but relieved after our treatment.In particular，routine blood test results were analyzed in detail.By literature review，we found that such patients have been rarely reported in China，whereas widely studied in abroad.Moreover，we summarized the problems resulting from combination medications for IBD，hoping to increase clinicians' knowledge about this disease and enhance their attention to its clinical diagnosis and management.

Key words: Inflammatory bowel diseases；Azathioprine；Mesalamine；Drug therapy, combination；Myelosuppression；Case reports；Literature review

杨元明,郑欢,黄绍刚,等. 硫唑嘌呤联合美沙拉嗪治疗炎症性肠病致急性骨髓抑制一例报道并文献回顾[J]. 中国全科医学, 2019, 22(23): 2893-2896. DOI: 10.12114/j.issn.1007-9572.2019.00.058.
YANG Yuanming,ZHENG Huan,HUANG Shaogang, et al. Acute Myelosuppression Secondary to Inflammatory Bowel Disease Treated with Azathioprine and Mesalazine：a Case Report and Literature Review　[J]. Chinese General Practice, 2019, 22(23): 2893-2896. DOI: 10.12114/j.issn.1007-9572.2019.00.058.

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