目的 探讨米氮平相关血小板减少的临床特点。 方法 报道航天中心医院收治的1例米氮平相关血小板减少患者的诊治经过，并对该例以及检索有关数据库（截至2023年8月31日）收集到的相关病例的主要临床资料（性别、年龄、米氮平用药指征、米氮平用法用量、联合用药情况、用药前后血小板计数、应用米氮平至发生血小板减少的时间、临床处理及转归等）进行描述性统计分析。 结果 纳入分析的患者共9例，男性4例，女性5例；年龄28~74岁，中位年龄52岁；用药指征为抑郁症者8例，1例无记录；米氮平日剂量15 mg者4例、30 mg者3例，2例无记录；单独使用米氮平者2例，合并使用其他药物者6例，1例无记录。9例患者应用米氮平至发生血小板减少的时间为2~28 d，中位时间8 d，血小板减少严重程度1、3、4级者分别为3、3、2例，1例无记录；发生严重血小板减少的5例患者中3例有出血症状，1例出现皮肤瘀斑。2例患者行药物依赖性抗血小板抗体检测，结果呈阳性。发生血小板减少后9例患者均停用米氮平，6例未予特殊干预，3例给予对症治疗；停药2~43 d（中位时间9 d）后，7例患者血小板计数恢复至参考值范围，1例PLT回升，1例不详但皮肤症状改善。 结论 米氮平相关血小板减少多发生于用药后10 d内，停药多可好转。建议应用米氮平前后注意监测患者的血常规。 Objective To explore the clinical characteristics of mirtazapine-related thrombocytopenia。 Methods The diagnosis and treatment of a patient with mirtazapine-related thrombocytopenia who was admitted to the Aerospace Center Hospital was reported， and the main clinical data (gender， age， indications of mirtazapine use， dosage of mirtazapine， combined medication， platelet count before and after medication， time from application of mirtazapine to thrombocytopenia occurrence， clinical treatment and prognosis， etc。) of the case and similar cases collected by searching relevant databases (up to August 31， 2023) were analyzed by descriptive statistic method。 Results A total of 9 patients were enrolled in the analysis， including 4 males and 5 females the age ranged from 28 to 74 years， with a median age of 52 years。 The indication of medication was depression in 8 patients， and 1 had no record。 The daily dose of mirtazapine was 15 mg in 4 patients， 30 mg in 3 patients， and no record in 2 patients。 Two patients were treated with mirtazapine alone， 6 patients were treated with mirtazapine combined with other drugs， and it was not recorded in 1 patient。 The time from the application of mirtazapine to occurrence of thrombocytopenia in the 9 patients ranged from 2 to 28 days， with a median time of 8 days。 The severity of thrombocytopenia was grade 1， 3， and 4 in 3， 3， and 2 patients， respectively 1 patient had no relevant record。 Of the 5 patients with severe thrombocytopenia， 3 developed bleeding， and 1 had skin ecchymosis。 The results of drug-dependent antiplatelet antibody test in 2 patients were positive。 Nine patients stopped mirtazapine treatment after diagnosis of thrombocytopenia， 6 patients did not receive special intervention， and 3 patients were given symptomatic treatments。 After drug withdrawal for 2-43 days with the median time of 9 days， platelet counts returned to the reference range in 7 patients， platelet count increased in 1 patient， and platelet count was unknown but skin symptom was improved in 1 patient。 Conclusions Mirtazapine-related thrombocytopenia usually occurs within 10 days of treatments， which can be improved after drug withdrawal。 It is suggested to monitor the blood routine before and after the application of mirtazapine。
Clinical and literature analysis on mirtazapine-related thrombocytopenia
Objective To explore the clinical characteristics of mirtazapine-related thrombocytopenia. Methods The diagnosis and treatment of a patient with mirtazapine-related thrombocytopenia who was admitted to the Aerospace Center Hospital was reported, and the main clinical data (gender, age, indications of mirtazapine use, dosage of mirtazapine, combined medication, platelet count before and after medication, time from application of mirtazapine to thrombocytopenia occurrence, clinical treatment and prognosis, etc.) of the case and similar cases collected by searching relevant databases (up to August 31, 2023) were analyzed by descriptive statistic method. Results A total of 9 patients were enrolled in the analysis, including 4 males and 5 females the age ranged from 28 to 74 years, with a median age of 52 years. The indication of medication was depression in 8 patients, and 1 had no record. The daily dose of mirtazapine was 15 mg in 4 patients, 30 mg in 3 patients, and no record in 2 patients. Two patients were treated with mirtazapine alone, 6 patients were treated with mirtazapine combined with other drugs, and it was not recorded in 1 patient. The time from the application of mirtazapine to occurrence of thrombocytopenia in the 9 patients ranged from 2 to 28 days, with a median time of 8 days. The severity of thrombocytopenia was grade 1, 3, and 4 in 3, 3, and 2 patients, respectively 1 patient had no relevant record. Of the 5 patients with severe thrombocytopenia, 3 developed bleeding, and 1 had skin ecchymosis. The results of drug-dependent antiplatelet antibody test in 2 patients were positive. Nine patients stopped mirtazapine treatment after diagnosis of thrombocytopenia, 6 patients did not receive special intervention, and 3 patients were given symptomatic treatments. After drug withdrawal for 2-43 days with the median time of 9 days, platelet counts returned to the reference range in 7 patients, platelet count increased in 1 patient, and platelet count was unknown but skin symptom was improved in 1 patient. Conclusions Mirtazapine-related thrombocytopenia usually occurs within 10 days of treatments, which can be improved after drug withdrawal. It is suggested to monitor the blood routine before and after the application of mirtazapine.
ThrombocytopeniaPancytopeniaMirtazapineAdverse drug reactions
万方数据
