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氯氮平所致心肌病一例报告

A Case Report of Clozapine-Induced Cardiomyopathy.

作者信息

Gourisaria Gourav, Sumanasan Navin, Ozen Goksu, Konduru Thejas Swaroop, Karunakaran Thozhuthumparambil Pradeep

机构信息

Acute Internal Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, GBR.

Endocrinology and Diabetes, Royal Glamorgan Hospital, Cardiff, GBR.

出版信息

Cureus. 2025 Jun 30;17(6):e87032. doi: 10.7759/cureus.87032. eCollection 2025 Jun.

DOI:10.7759/cureus.87032
PMID:40741548
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12309623/
Abstract

Clozapine is an antipsychotic medication prescribed for patients who do not respond to or cannot tolerate standard antipsychotic treatments. It is also used to manage psychosis associated with Parkinson's disease. As a high-risk drug, clozapine requires strict monitoring. A rare but serious side effect is cardiomyopathy, which necessitates discontinuation of the medication. This report presents the case of a 42-year-old male patient admitted with recurrent falls and urinary sepsis while on clozapine. He exhibited persistent tachycardia and drowsiness and was diagnosed with cardiomyopathy, likely induced by clozapine.

摘要

氯氮平是一种抗精神病药物,用于治疗对标准抗精神病治疗无反应或无法耐受的患者。它也用于治疗与帕金森病相关的精神病。作为一种高风险药物,氯氮平需要严格监测。一种罕见但严重的副作用是心肌病,这需要停药。本报告介绍了一名42岁男性患者的病例,该患者在服用氯氮平期间因反复跌倒和尿脓毒症入院。他表现出持续性心动过速和嗜睡,被诊断为可能由氯氮平引起的心肌病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88e0/12309623/0550b3db671d/cureus-0017-00000087032-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88e0/12309623/0550b3db671d/cureus-0017-00000087032-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88e0/12309623/0550b3db671d/cureus-0017-00000087032-i01.jpg

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1
A Case Report of Clozapine-Induced Cardiomyopathy.氯氮平所致心肌病一例报告
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本文引用的文献

1
Patients' Experiences of Clozapine for Treatment-Resistant Schizophrenia: A Systematic Review.氯氮平治疗难治性精神分裂症患者的体验:一项系统评价
Schizophr Bull Open. 2022 Jul 10;3(1):sgac042. doi: 10.1093/schizbullopen/sgac042. eCollection 2022 Jan.
2
Routine Electrocardiogram Screening and Cardiovascular Disease Events in Adults.常规心电图筛查与成年人的心血管疾病事件。
JAMA Intern Med. 2024 Sep 1;184(9):1035-1044. doi: 10.1001/jamainternmed.2024.2270.
3
The Protective Effect of Clozapine on Suicide: A Population Mortality Study of Statewide Autopsy Records in Maryland.
氯氮平对自杀的保护作用:马里兰州全州尸检记录的人群死亡率研究。
J Clin Psychiatry. 2023 Mar 15;84(3):22m14587. doi: 10.4088/JCP.22m14587.
4
Bioactivation of clozapine by mitochondria of the murine heart: Possible cause of cardiotoxicity.氯氮平在鼠心脏线粒体中的生物活化:可能导致心脏毒性的原因。
Toxicology. 2021 Jan 15;447:152628. doi: 10.1016/j.tox.2020.152628. Epub 2020 Nov 7.
5
Incidence and Management of Clozapine-Induced Myocarditis in a Large Tertiary Hospital.大医院中氯氮平诱导心肌炎的发病与处理。
Can J Psychiatry. 2019 Aug;64(8):561-567. doi: 10.1177/0706743718816058. Epub 2019 Jan 1.
6
Safety of antipsychotics for the treatment of schizophrenia: a focus on the adverse effects of clozapine.抗精神病药物治疗精神分裂症的安全性:聚焦氯氮平的不良反应
Ther Adv Drug Saf. 2018 May;9(5):237-256. doi: 10.1177/2042098618756261. Epub 2018 Feb 6.
7
Clozapine and Long-Term Mortality Risk in Patients With Schizophrenia: A Systematic Review and Meta-analysis of Studies Lasting 1.1-12.5 Years.氯氮平与精神分裂症患者的长期死亡风险:持续 1.1-12.5 年的研究的系统评价和荟萃分析。
Schizophr Bull. 2019 Mar 7;45(2):315-329. doi: 10.1093/schbul/sby052.
8
Clozapine-induced cardiomyopathy and myocarditis monitoring: A systematic review.氯氮平诱导的心肌病和心肌炎监测:系统评价。
Schizophr Res. 2018 Sep;199:17-30. doi: 10.1016/j.schres.2018.03.006. Epub 2018 Mar 13.
9
Clozapine, elevated heart rate and QTc prolongation.氯氮平、心率升高与QTc间期延长。
J Psychiatry Neurosci. 2018 Jan;43(1):71-72. doi: 10.1503/jpn.170135.
10
Clozapine-induced, dilated cardiomyopathy: a case report.氯氮平诱发的扩张型心肌病:一例报告
BMC Res Notes. 2017 Jul 27;10(1):338. doi: 10.1186/s13104-017-2679-5.