Şizofreni Hastalarında Antipsikotik Tedavilerin Nötrofil/Lenfosit, Trombosit/Lenfosit, Monosit/Lenfosit, Monosit/HDL Oranları ve Sistemik İmmün İnflamatuvar İndeks Değerleri Üzerindeki Rolü

Yıl 2025, Cilt: 35 Sayı: 4, 640 - 648, 29.08.2025

Memduha Aydın , Hacer Söylemez

https://doi.org/10.54005/geneltip.1645072

Öz

ÖZET
Amaç: Anormal sistemik inflamatuar yanıtlar şizofreni patogenezinde önemli bir rol oynamaktadır. Nötrofil-lenfosit oranı (NLR), trombosit-lenfosit oranı (PLR), monosit-lenfosit oranı (MLR), monosit-HDL oranı (MHR) ve sistemik immün inflamasyon indeksi (SII) son zamanlarda inflamasyon belirteçleri olarak kullanılmaktadır. Çalışmamızın amacı şizofreni hastalarında NLR, PLR, MLR, MHR ve SII değerleri ile antipsikotik tedaviler arasındaki ilişkiyi incelemektir.
Gereç ve Yöntem: Selçuk Üniversitesi Tıp Fakültesi, Psikiyatri Ana Bilim Dalı, Psikotik Bozukluklar Polikliniği'nde takip edilen şizofreni tanılı yüz doksan dört birey çalışmaya dahil edilmiştir. Nötrofil, lenfosit, trombosit ve monosit sayıları, HDL değerleri kan testlerinden retrospektif olarak elde edildi. NLR, PLR, MLR, MHR ve SII hesaplandı.
Bulgular: Hastaların yaş ortalaması 44,38 ± 12,67 yıldı. Toplam 85 (%43,8) hasta kadındı. PLR ve SII kadınlarda erkeklere göre istatistiksel olarak anlamlı derecede yüksekti (p<0.001, p<0.018). Hasta grupları arasında, MHR düzeyleri erkek grupta kadın gruba göre istatistiksel olarak anlamlı derecede yüksekti (p<0.003). Şizofreni hastalarında kullanılan farklı antipsikotik tedaviler arasında inflamatuar belirteçler açısından anlamlı bir farklılık saptanmadı (p> 0.05). Ancak, paliperidon uzun etkili enjektabl tedavi süresi ile NLR ve SII arasında negatif bir korelasyon bulundu (PP-LAI ve NLR, r:-0.26, p=0.026; PP-LAI ve SII, r:-0.26, p=0.03).
Sonuç: Bulgularımız, paliperidon uzun etkili enjektabl tedavi süresi ile NLR ve SII arasında negatif bir korelasyon olduğunu göstermektedir. Bu sonuç daha uzun süreli paliperidon uzun etkili tedavinin inflamasyonun azalmasına katkıda bulunabileceğini düşündürmektedir. Ayrıca, sonuç olarak PLR, MHR ve SII'de cinsiyetler arasında farklılıklar bulunmuştur. Cinsiyete dayalı farklılıkların ve antipsikotik tedavilerin inflamatuar belirteçler üzerindeki rolünün anlaşılmasının şizofreni patogenezinin daha iyi anlaşılmasını sağlayabileceği ve daha iyi tedavi seçeneklerinin bulunmasına yardımcı olabileceği düşünülmektedir.

Anahtar Kelimeler

Antipsikotik , inflamatuar yanıt , monosit/HDL oranı , monosit/lenfosit oranı , nötrofil/lenfosit oranı , trombosit/lenfosit oranı , sistemik immün inflamatuar indeks , şizofreni

The Role of Antipsychotic Treatments in Neutrophil/Lymphocyte, Platelet/Lymphocyte, Monocyte/Lymphocyte, Monocyte/HDL Ratios and Systemic Immune Inflammatory Index Values for Patients with Schizophrenia

Öz

ABSTRACT

Backround/Aims: Abnormal systemic inflammatory responses play a significant role in pathogenesis of schizophrenia. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), monocyte-HDL ratio (MHR) and systemic immune inflammation index (SII) have recently been used as markers of inflammation. The aim of our study is to examine the relationship between NLR, PLR, MLR, MHR, and SII values of patients diagnosed with schizophrenia and antipsychotic treatments.

Methods: One hundred ninety four individuals diagnosed with schizophrenia who were followed up in Psychotic Disorders Polyclinic of the Selcuk University Faculty of Medicine, were included in the study. Neutrophil, lymphocyte, platelet and monocyte counts, HDL values were obtained retrospectively from blood tests. NLR, PLR, MLR, MHR, and SII were calculated.

Results: The mean age of patients was 44.38 ± 12.67 years. In total, 85 (43.8 %) patients were female. PLR, and SII were statistically significantly greater in females than in male group (p<0.001, p<0.018). Among the patient groups, MHR levels were significantly higher in the male group than in the female group (p<0.003). No significant difference was found between different antipsychotic treatments used in schizophrenia patients in terms of inflammatory markers (p > 0.05). However, a negative correlation was found between paliperidone long-acting injectable treatment duration and NLR and SII (PP-LAI and NLR, r: -0.26, p=0.026; PP-LAI and SII, r: -0.26, p=0.03).

Conclusion: Our findings demonstrate a negative correlation between the duration paliperidone long-acting injectable treatment and NLR and SII. This suggests that a longer duration of paliperidone long-acting treatment may contribute to a reduction in inflammation. Also, differences were found between genders in PLR, MHR, and SII as a result. It is thought that understanding the gender-based differences and role of antipsychotic treatments on inflammatory markers may provide better understanding of schizophrenia pathogenesis and help to find better treatment options.

Anahtar Kelimeler

Antipsychotic , inflammatory response , monocyte/HDL ratio , monocyte/lymphocyte ratio , neutrophil/lymphocyte ratio , platelet/lymphocyte ratio systemic immune inflammatory index , schizophrenia

Etik Beyan

Patients were evaluated after approval was obtained Ethics Committee (Decision No: 2023/482, Selcuk University Faculty of Medicine-2023).

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