摘要
1例31岁女性精神分裂症患者服用氯氮平(50 mg/d)治疗期间自然怀孕,且孕期一直服用该药治疗。产前胎儿行超声及染色体检查均未见明显异常。母亲孕期先后因妊娠期糖尿病和轻度贫血接受门冬胰岛素注射液、地特胰岛素注射液皮下注射及多糖铁复合物胶囊口服治疗。孕39 +2周剖宫产分娩1例男性活婴,体重3 280 g,Apgar评分为10分。新生儿查体:四肢皮肤散在瘀斑,全身皮肤散在针尖样出血点,心脏听诊心律不齐。实验室检查:血小板计数366×10 9/L;凝血酶原时间14.4 s,活化部分凝血活酶时间69.4 s,凝血酶时间22.9 s,纤维蛋白原1.27 g/L。诊断为新生儿凝血功能障碍,考虑可能与氯氮平有关。给予静脉滴注维生素K 1注射液和人纤维蛋白原。4 d后患儿全身瘀斑瘀点较前减少,凝血酶原时间11.4 s,活化部分凝血活酶时间45.0 s,凝血酶时间20.6 s,纤维蛋白原2.22 g/L。8 d后瘀斑和瘀点基本消退。
A 31-year-old female patient with schizophrenia got pregnant naturally during the treatment with clozapine(50 mg/d)and had been taking the drug during the pregnancy.Prenatal fetal ultrasound and chromosome examination showed no obvious abnormalities.The mother received subcutaneous injections of insulin aspart injection and insulin detemir injection and oral iron polysaccharide complex capsules for gestational diabetes mellitus and mild anemia successively during pregnancy.One live male infant was delivered by cesarean section at 39+2 weeks of gestation,with a birth weight of 3280 g.The infant's Apgar score was 10.Physical examination of the newborn showed scattered ecchymosis on limbs skin,pinpoint-like petechiae on whole-body skin,and arrhythmia by heart auscultation.Laboratory tests showed prothrombin time 14.4 s,activated partial thromboplastin time 69.4 s,thrombin time 22.9 s,fibrinogen 1.27 g/L.and platelet count 366×109/L.Neonatal coagulation dysfunction was diagnosed,which was considered to be possibly related to clozapine.Intravenous infusions of vitamin K1 injection and human fibrinogen were given.Four days later,ecchymosis and petechiae on his whole body were less than before,prothrombin time was 11.4 s,activated partial thromboplastin time was 45.0 s,thrombin time was 20.6 s,and fibrinogen was 2.22 g/L.Eight days later,his ecchymosis and petechiae basically disappeared.
作者
胡叶敏
黄亮
文显容
罗浩
Hu Yemin;Huang Liang;Wen Xianrong;Luo Hao(Department of Pharmacy,Luzhou Maternal and Child Health Care Hospital(Luzhou Second People's Hospital),Sichuan Province,Luzhou 646000,China;Department of Pharmacy,West China Second University Hospital,Sichuan University,Chengdu 610041,China)
出处
《药物不良反应杂志》
CSCD
2020年第11期644-645,共2页
Adverse Drug Reactions Journal
关键词
氯氮平
母亲暴露
新生儿
血液凝固障碍
Clozapine
Maternal exposure
Infant,newborn
Blood coagulation disorders
