500例精神病患者服用抗精神病药物后致白细胞减少的回顾性分析

Leukopenia induced by antipsychotic drugs:a retrospective analysis based on 500 cases of psychosis

目的探讨精神病患者服用抗精神病药物后致白细胞减少的特点,为临床用药提供参考。方法收集医院收治的500例各类精神病患者的临床资料,回顾患者基本资料、用药种类、用药方法、白细胞减少程度的分布情况、白细胞减少的时间和临床症状等。结果 500例精神病患者中白细胞减少者144例(28.8%),其中白细胞计数3~4×109/L者98例(68.1%),2~3×109/L者42例(29.2%),<2×109/L者4例(2.8%);服用第一代药物致白细胞减少者的比例高于服用第二代药物者,联合用药致白细胞减少者的比例高于单一用药者,差异均有统计学意义(均P<0.05)。治疗后,所有患者白细胞均恢复至正常范围,无严重感染、败血症等严重后果。结论部分精神病患者服用抗精神病药物后可导致白细胞减少,以服用第一代药物者和联合用药者居多。

Objective To understand the mechanism of leukopenia induced by antipsychotic drugs with a view to improvingclinical medication for the patients.Method The clinical data of500patients with psychosis were firstly collected.The basic data,types of drugs,methods of administration,distribution of leukopenia,time and clinical symptoms of leukopenia were then systematically reviewed.Findings144cases(28.8%)of leukopenia were found ofthe500patients with psychosis,which included98cases(68.1%)of white blood cell count of3~4×109/L,42cases(29.2%)of2~3×109/L,<2×109/L in4cases(2.8%).The proportion of leukopenia in the first generation of drugs was significantly higher than that in the second generation,and the proportion of leukopenia with combined drugs was significantly higher than that of single drug,which were statistically significant(all P<0.05).All leukopenia were not serious infection,sepsis and other serious consequences.Conclusion A subset of psychiatric patients can lead to leukopenia after taking antipsychotic drugs.It is mainly due to the use of first-generation drugs and combined drugs.