人类白细胞抗原和氯氮平诱发的粒细胞缺乏症

Associations between Human Leukocyte Antigen and clozapine induced agranulocytosis

目的探讨氯氮平诱发的粒细胞缺乏症（简称为粒缺）与人类白细胞抗原（ＨＬＡ）的相关关系。方法对２９例精神分裂症患者进行了ＨＬＡ分型研究。结果２９例中７例发生粒缺患者的ＨＬＡ－ＤＲ１２（５）抗原频率显著高于２２例粒缺未发生的患者，Ｐ＜０．０１。在精神分裂症患者与健康对照组之间，未发现该抗原频率差异有显著性。结论提示服用氯氮平发生粒缺的患者可能有特异的遗传素质，遗传基础与ＨＬＡ－ＤＲ１２（５）基因有关，相对危险性（ＲＲ）＝３８．１５６，而与疾病自身因素无关。

Objective This study determined association between human leukocyte antigen (HLA) and the development of clozapine induced agranulocytosis (CA). Methods HLA typing was performed in a group of 29 clozapine treated schizophrenic patients. Results 7 of the patients had developed CA. The frequencies of HLA DR 12(5) was significantly higher in CA patients that those without CA. No significant difference was found between 22 patients without CA and 51 healthy volunteers. Conclusion The results suggests that CA patients may have genetic predisposition, which is associated with HLA DR 12(5) (relative risk=38.156), other than schizophrenia.