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氯氮平(clozapine)对精神分裂症的阳性症状或阴性症状有较好疗效,虽然不良反应较多,但因价格低廉在一些经济欠发达地区的精神病专科医院临床应用仍占较大比例。常见的不良反应已被逐渐重视,但少见的严重不良反应时有发生。现将我院在2002年7月至2006年3月所遇因氯氮平致急性肺水肿5例病例报告如下。1 资料与方法1.1 一般资料本组5例病例均诊断精神分裂症,单一应用氯氮平治疗。男性3例,女性2例,年龄17～45岁,平均年龄35岁。服用氯氮平50 mg～275 mg/d,平均剂量150mg/d。发生肺水肿时间:2例发生在入院第3天夜晚12时至次日凌晨1时左右,2例发生在入院第5天凌晨2～3时左右,1例发生在第4天下午4时左右。5例病例被发现时均处于仰卧位深睡状态。1.2 临床诊断①临床表现为呼吸困难,发绀,口鼻溢出白色泡沫样痰。②体征:双肺可闻及广泛性、大、小湿性罗音,喉头有痰鸣音。③服用氯氮平期间深睡眠时发病。④既往无心脏病、呼吸系统疾病,输液过量、过快,中枢神经系统疾病史。⑤X线胸片两肺蝶形状模糊阴影。
Clozapine has a good effect on the positive or negative symptoms of schizophrenia. Although there are more adverse reactions, clozapine still occupies a large proportion of clinical applications in psychiatric hospitals in economically underdeveloped areas due to its low price. Common adverse reactions have been gradually valued, but rare serious adverse reactions occur from time to time. Now in our hospital in July 2002 to March 2006 due to clozapine caused by acute pulmonary edema in 5 cases reported as follows. 1 Materials and Methods 1.1 General Information The group of 5 cases were diagnosed schizophrenia, a single application of clozapine treatment. 3 males and 2 females, aged 17 to 45 years old, with an average age of 35 years. Taking clozapine 50 mg ~ 275 mg / d, the average dose of 150 mg / d. Occurrence of pulmonary edema time: 2 cases occurred on the 3rd night of admission from 12 o’clock to 1:00 the next morning, 2 cases occurred in the first 5 days of admission about 2 to 3 o’clock in the morning, 1 case occurred on the 4th day at about 4 pm . Five cases were found in deep sleep in the supine position. 1.2 clinical diagnosis ① clinical manifestations of dyspnea, cyanosis, mouth and nose overflow white foam-like sputum. ② signs: the lungs can be broad and widespread, large and small wet rales, throat sputum beeps. ③ take clozapine incidence during deep sleep. ④ no previous heart disease, respiratory diseases, excessive infusion, too fast, history of central nervous system diseases. ⑤ X-ray two lung butterfly shape fuzzy shadow.