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Yıl:2003; Cilt: 13; Sayı: 2>> Özet
TAM METİN
Klinik Psikofarmakoloji Bülteni; 2003;13(2):50-56
Tipik antipsikotiklerle tedavi edilen şizofreni hastalarında koroner kalp hastalığı riskinin değerlendirilmesi
H Demirci, N Kosku, Y Çınar, C İlnem
SSK Bursa Şevket Yılmaz Hastanesi, Aile Hekimliği, Bursa
Amaç: Son çalışmalarda, şizofreni hastalarında antipsikotik ilaçları n etkilerinden bağımsız, artmış ateroskleroz riski ve ani kardiyak ölüm tartışılmaktadır. Bu çalışmada amaç, şizofreni hastalarında koroner kalp hastalığı risk faktörlerini incelemektir. Yöntem: Kesitsel tip, vaka-kontrol çalışması şeklinde planlanan bu çalışmada, yatan ve tipik antipsikotik ilaçlarla tedavi edilen 69 şizofreni hastası değerlendirildi. Yaş, sigara alışkanlığı, vücut kitle indeksi, kan basıncı ve total kolesterol, HDL, LDL, trigliseritler, albumin, ürik asit, açlık glukozu ve postprandial glikoz değerleri incelemeye dahil edildi. Koroner kalp hastalığı riski, Framingham risk tahmin kartları kullanılarak hesaplandı. Şizofreni grubundan edinilen veriler, cinsiyet ve yaş ortalaması benzer, sağlıklı 26 kişiden oluşan kontrol grubu verileri ile istatistiksel olarak karşılaştı- rıldı. Bulgular: Tahmin edilen koroner kalp hastalığı risk toplamı, şizofreni grubunda %5.99 ve kontrol grubunda %6.46 olup, iki grup arasındaki fark istatistiksel olarak anlamlı bulunmadı. Aterosklerozdan koruyucu bir faktör olarak bilinen serum HDL seviyeleri, ilerleyen yaşla beraber kontrol grubunda düşme eğilimi gösterirken; ilginç bir şekilde şizofreni hastalarında tam tersi eğilimle, yaş arttıkça yükseldiği saptandı. Sonuç: Koroner kalp hastalığı Framingham risk skorları şizofreni hastalarında kontrol grubuna kıyasla yüksek bulunmadı. Genç şizofreni hastalarında gözlenen düşük HDL seviyelerinin, şizofreni hastalığında görülen erken ölümleri kısmen açıklayabileceği düşünülmektedir
Evaluation of coronary heart disease risk in patients with schizophrenia who were treated with typical antipsychotics
Objective: Increased risk of atherosclerosis and sudden cardiac death in patients with schizophrenia regardless of the effect of antipsychotic agents are discussed in recent studies. Our aim in this study is to evaluate coronary heart disease risk factors in patients with schizophrenia. Method: Sixty-nine in patients with schizophrenia who were treated only with typical antipsychotic medications were included in this cross sectional case control study. Age, tobacco consumption, body mass index, arterial blood pressure and laboratory tests including total cholesterol, HDL, LDL, triglycerides, albumin, uric acid, fasting glucose and postprandial glucose levels were evaluated. Coronary hearth disease risks of the patients were estimated by using Framingham Risk Prediction Charts. The obtained data were compared with 26 healthy age and gender matched comparison subjects. Results: The mean estimated coronary heart disease risk sum is 5.99 in patients with schizophrenia and 6.46 in control. The difference between two groups was not statistically significant. Interestingly, there was a continual increase of serum HDL levels, that is known as a protective factor from atherosclerosis with progressive age in patients with schizophrenia but an opposite tendency was found in controls. Conclusions: The estimated risk of coronary heart disease was not increased in patients with schizophrenia. It is thought that the lower HDL levels of younger patients with schizophrenia may partly explain premature deaths seen in schizophrenia

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