정신신체의학 (Korean Journal of Psychosomatic Medicine)

한국정신신체의학회 (Korean Psychosomatic Society)
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조현병/조현정동장애 환자에서 1년간의 Clozapine 투여가 혈소판 활성도에 미치는 영향에 관한 후향적 연구

A Retrospective Study on the Effect of 1-Year Clozapine Administration on Platelet Activity in Patients with Schizophrenia or Schizoaffective Disorder

  • 장은자 (건양대학교 의과대학 정신건강의학과교실) ;
  • 이종욱 (건양대학교 명곡의과학연구소) ;
  • 김승준 (건양대학교 의과대학 정신건강의학과교실) ;
  • 오홍석 (건양대학교 의과대학 정신건강의학과교실) ;
  • 이나현 (건양대학교 의과대학 정신건강의학과교실) ;
  • 임우영 (건양대학교 의과대학 정신건강의학과교실) ;
  • 김지웅 (건양대학교 의과대학 정신건강의학과교실)
  • Jang, EunJa (Department of Psychiatry, College of Medicine, Konyang University) ;
  • Lee, Jong Wook (Konyang University Myunggok Medical Research Institute) ;
  • Kim, Seung-Jun (Department of Psychiatry, College of Medicine, Konyang University) ;
  • Oh, Hong-Seok (Department of Psychiatry, College of Medicine, Konyang University) ;
  • Im, Woo Young (Department of Psychiatry, College of Medicine, Konyang University) ;
  • Lee, Na-Hyun (Department of Psychiatry, College of Medicine, Konyang University) ;
  • Kim, Ji-Woong (Department of Psychiatry, College of Medicine, Konyang University)
  • 투고 : 2020.04.02
  • 심사 : 2020.05.16
  • 발행 : 2020.06.30
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초록

연구목적 클로자핀은 뇌심혈관 질환의 발생가능성을 높이는 것으로 알려져 있으며, 혈소판의 활성화 정도는 뇌심혈관 질환의 발생과 관련이 있을 것으로 생각되어왔다. 저자들은 이전 연구에서 단기간의 클로자핀 투여 후 혈소판 활성도가 증가함을 관찰하였다. 본 연구는 이에 대한 후속 연구로 클로자핀을 1년의 기간 동안 장기간 지속 투여하였을 때, 혈소판 활성도에 어떤 영향을 미치는지를 알아보기 위해 시행하였다. 방 법 조현병 혹은 조현정동장애의 치료를 위해 최소 1년의 기간 동안 지속적으로 클로자핀을 투여 받은 환자들의 의무기록을 후향적으로 검토하였다. 혈소판의 활성도는 평균혈소판요소 값을 이용하여 측정하였다. 결 과 총 24명의 환자를 대상으로 하였고, 연구 대상자 중 남성은 9명(37.5%), 여성은 15명(62.5%) 였다. 윌콕슨부호-순위검정에서 초기 및 1년 경과 시점에서의 평균혈소판요소 값 사이의 유의한 변화는 관찰되지 않았다. 결 론 1년간의 지속적인 클로자핀 투여에도 평균혈소판요소의 유의한 변화가 관찰되지 않았다. 단기간의 클로자핀 투여 시 평균혈소판요소 값에 현저한 저하를 관찰하였던 저자들의 이전의 연구 결과를 함께 고려해 볼 때, 본 연구의 결과는 클로자핀 투여 기간에 따라 혈소판의 활성도가 변화할 가능성을 시사한다.

Objectives : Clozapine has been known to increase the possibility of developing cardio/cerebrovascular diseases, and the platelet activation has been deemed to be related to the occurrence of them. In author's previous study, we observed the increase of platelet activity with short-term clozapine administration. This study was conducted, as a follow-up study, to investigate the effect of clozapine on the platelet activity when administered continuously for long-term period of time of 1 year. Methods : The medical records of the patients with schizophrenia or schizoaffective disorder who were treated with clozapine for 1 year were retrospectively reviewed. The degree of platelet activation was assessed by measuring the mean platelet component. Results : Total of 24 patients were enrolled. 9 of them (37.5%) were male and 15 of them (62.5%) were female. In the Wilcoxon sign-ranks test, no significant change was observed between the mean platelet factor values at the beginning and at the end of one year. Conclusions : No significant changes of mean platelet activity were observed after continued administration of clozapine for 1 year. Considering the author's previous findings that observed a prominent decrease of mean platelet component after short-term clozapine administration, the result of this study suggests the possibility that the activity of the platelet may change depending on the duration of the clozapine administration.

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