Nielsen Jimmi, Foldager Leslie, Meyer Jonathan M
Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aarhus University Hospital, Mølleparkvej 10, PO Box 210, DK-9100 Aalborg, Denmark.
Eur Neuropsychopharmacol. 2009 Jul;19(7):483-6. doi: 10.1016/j.euroneuro.2009.03.002. Epub 2009 Apr 7.
Clozapine has the potential to cause agranulocytosis and an association to an increased risk of infections has been suggested. Patients with an ICD-10 F20.x were identified from the Danish Central Psychiatric Research Registry and were linked to the national prescription database to identify schizophrenia patients treated with clozapine from 1996 to 2005(N=3374). Binomial regression and Cox proportional hazards models were used. An increased use of antibiotics was found RR=1.43, CI: 1.26-1.61, P<0.0001 and HR 1.14, 95% CI: 1.05-1.24, P=0.0025 with binomial regression and Cox proportional hazard model, respectively. The exact mechanism for the increased risk remains unknown, but the increased risk might be due to aspiration pneumonia caused by hypersalivation and the sedating properties of clozapine. The findings reported here should alert clinicians to be mindful of infectious processes as yet another possible somatic manifestation of clozapine treatment.
氯氮平有导致粒细胞缺乏症的风险，并且有人提出其与感染风险增加有关。从丹麦中央精神病学研究登记处识别出国际疾病分类第十版（ICD - 10）F20.x编码的患者，并将其与国家处方数据库关联，以确定1996年至2005年期间接受氯氮平治疗的精神分裂症患者（N = 3374）。使用了二项式回归和Cox比例风险模型。结果发现抗生素使用增加，二项式回归和Cox比例风险模型得出的相对危险度（RR）分别为1.43，置信区间（CI）：1.26 - 1.61，P < 0.0001；风险比（HR）为1.14，95% CI：1.05 - 1.24，P = 0.0025。风险增加的确切机制尚不清楚，但风险增加可能是由于唾液分泌过多引起的吸入性肺炎以及氯氮平的镇静作用。此处报告的研究结果应提醒临床医生注意感染过程，这是氯氮平治疗另一种可能的躯体表现。
