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Vojnosanitetski pregled
2015, vol. 72, br. 12, str. 1085-1092
jezik rada: engleski
vrsta rada: originalan članak
objavljeno: 14/12/2015
doi: 10.2298/vsp140526016s
Efekat antipsihotika na nespecifične markere inflamacije u prvoj epizodi shizofrenije
aKlinički centar Srbije, Klinika za psihijatriju, Beograd
bUniverzitet u Kragujevcu, Medicinski fakultet
cKlinički centar Srbije, Klinika za psihijatriju, Beograd + Univerzitet u Kragujevcu, Medicinski fakultet
dUniverzitet u Beogradu, Medicinski fakultet, Institut za medicinsku statistiku i informatiku

e-adresa: vesnastef@open.telekom.rs

Sažetak

Uvod/Cilj. U razmatranju još uvek nepoznate etiologije shizofrenije, disfunkcija imunskog sistema koja uključuje i inflamaciju zauzima značajno mesto. Cilj našeg rada bio je da se odrede koncentracije nespecifičnih markera zapaljenja u krvi, u prvoj epizodi shizofrenije i njihova povezanost sa terapijskim odgovorom na antipsihotike. Metode. U radu smo određivali koncentracije nespecifičnih markera zapaljenja u krvi: leukocita (WBC), C-reaktivnog proteina (CRP), sedimentacije eritrocita (SE) i elemenata leukocitarne formule: granulocita (Gra), limfocita (Lym) i monocita (Mon), i to u prvoj epizodi šizofrenije, kod 78 hospitalizovanih bolesnika u Klinici za psihijatrijske bolesti 'Dr Laza Lazarević' u Beogradu. Njihove koncentracije određivali smo pri prijemu i četiri sedmice nakon antipsihotičke terapije. Težinu psihopatologije i farmakoterapijski odgovor pratili smo primenom Skale pozitivnih i negativnih sindroma shizofrenije (Positive and negative syndrome scale for schizophrenia - PANSS). Rezultati. U prvoj epizodi shizofrenije, pre uvođenja antipsihotika, postojala je visoka učestalost abnormalnih laboratorijskih vrednosti (≥ 25% bolesnika) sledećih nespecifičnih markera inflamacije: WBC, CRP i SE, kao i Gra u leukocitarnoj formuli, ali i smanjenje svih njih nakon četiri sedmice antipsihotičke terapije, na nivou visoke statističke značajnosti za WBC i Gra (p < 0.001). Sedimentacija eritrocita ostala je povećana kod čak 50% bolesnika i nakon 4- sedmičnog antipsihotičkog lečenja, na nivou statističke značajnosti kod onih koji nisu reagovali na terapiju u odnosu na one koji jesu (p = 0.045 ). Zaključak. Dobijeni rezultati pokazuju da u prvoj epizodi shizofrenije kod subpopulacije bolesnika postoje povećane vrednosti nespecifičnih markera inflamacije u krvi (WBC, CRP , SE i Gra iz leukocitarne formule), sa tendencijom njihove normalizacije nakon četiri sedmice antipsihotičkog tretmana.

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