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氯氮平是一种效果优于经典神经阻断药的抗精神病药,其主要不良反应之一是粒细胞缺乏症。氯氮平所致粒细胞缺乏的发生率为1～2%,但晚近美国估计的累积危险性在治疗1年后为0.80%,1年半后为0.92%。粒细胞缺乏通常在治疗头6个月内发生,第4～18周的危险性最高,尽管确切的发病机制不清,但与直接药物中毒或毒性代谢物蓄积机制相比,某些资料更倾向于免疫中介机制。Pisciotta等发现了一种针对中性白细胞和其定型前体具有细胞毒性作用的短暂性抗体产物。此抗体在氯氮平引起粒细胞缺乏期间短时出现。
Clozapine is an antipsychotic agent that is superior to classical neuroleptic agents and one of the major side effects is agranulocytosis. The incidence of agranulocytosis due to clozapine is 1-2%, but the cumulative risk recently estimated in the United States was 0.880% after 1 year of treatment and 0.92% after 1 year and a half. Agranulocytosis usually occurs within the first 6 months of treatment, with the highest risk at weeks 4-18, and although the exact pathogenesis is unclear, some of the data are more likely than direct drug toxicity or toxic metabolite accumulation mechanisms In the immune intermediary mechanism. Pisciotta et al. Found a transient antibody product that has cytotoxic effects on neutrophils and their stereotype precursors. This antibody appears shortly during clozapine-induced agranulocytosis.