Canoso R T, Sise H S
Am J Hematol. 1982 Sep;13(2):121-9. doi: 10.1002/ajh.2830130204.
Chronic administration of chlorpromazine is associated with the development of a lupus-like circulating anticoagulant and a variety of immunological abnormalities. The prevalence of these findings was studied in 123 psychiatric patients. The anticoagulant was present in 11 of 30 patients receiving chlorpromazine (CPZ), in none of 17 patients who had been off phenothiazine therapy for over a year and in none of 53 controls. It was also seen in 5 of 13 patients who had been switched from CPZ to another phenothiazine even after several years being off CPZ. The anticoagulant was characterized by prolongation of the partial thromboplastin time, thromboplastin dilution test, and Russell's viper venom time. Washed frozen platelets partially corrected the abnormality induced by the anticoagulant. In all but one case the anticoagulant was associated with positive antinuclear antibody test and/or increased serum IgM. Six of 16 patients also had decreased complement levels, and two had a positive direct Coombs' test. None of these patients manifested bleeding, hemolysis, splenomegaly, or other clinical features of systemic lupus erythematosus.
长期服用氯丙嗪与出现狼疮样循环抗凝物质及多种免疫异常有关。对123例精神科患者中这些发现的发生率进行了研究。在30例服用氯丙嗪（CPZ）的患者中有11例出现抗凝物质，在17例已停用吩噻嗪类药物超过一年的患者中无一例出现，在53例对照者中也无一例出现。在13例从CPZ换用另一种吩噻嗪类药物的患者中，即使在停用CPZ数年之后，仍有5例出现抗凝物质。该抗凝物质的特征为部分凝血活酶时间、凝血活酶稀释试验及蝰蛇毒时间延长。洗涤冷冻血小板可部分纠正由该抗凝物质所致的异常。除1例之外，所有病例中的抗凝物质均与抗核抗体试验阳性和/或血清IgM升高有关。16例患者中有6例补体水平降低，2例直接抗人球蛋白试验阳性。这些患者均未表现出出血、溶血、脾肿大或系统性红斑狼疮的其他临床特征。
