MECT联合SSRI类药物治疗难治性抑郁症有效性和安全性Meta分析  

Efficacy and safety of MECT plus SSRI in the treatment of refractory depression:a Meta analysis

作　　者：周林科[1] 郭菁[1] 徐忆[1] 王啸[1] 谢鹏[1] 

机构地区：[1]重庆医科大学附属第一医院神经内科,重庆400016

出　　处：《重庆医科大学学报》2014年第6期853-857,共5页Journal of Chongqing Medical University

基　　金：国家重点基础研究发展计划资助项目(973计划)(编号:2009CB918302)

摘　　要：目的:评价改良电休克(modified electroconvulsive therapy,MECT)联合选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitor,SSRI)治疗难治性抑郁症的有效性和安全性。方法:通过检索Cochrane Library、PubMed、Web of Knowledge、EBSCO、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、万方数据库(CECDB)、维普中文科技期刊全文数据库(CQVIP),检索年限不限,筛选随机对照试验(randomized controlled trials,RCTs),并对纳入文献进行质量评价和数据提取,用Review manager 5.0软件对纳入的RCTs进行Meta分析。结果:纳入7个RCTs共461名患者,其中MECT联合治疗组230例,SSRI药物治疗组231例。Meta分析结果指出MECT联合治疗组患者治愈率和有效率均高于SSRI药物治疗组,差异具有统计学意义(分别为治愈率Z=4.52,P=0.000;有效率Z=7.71,P=0.000),且副反应中MECT联合治疗组中近事记忆障碍的发生率要高于SSRI药物治疗组(P=0.013),其余的副反应发生率比较均无统计学意义(P>0.05)。结论:与单独SSRI药物治疗相比,MECT联合SSRI治疗可明显提高难治性抑郁症患者的有效率和治愈率,具有临床指导意义。Objective：To access the efficacy and safety of MECT plus SSRI in the treatment of refractory depression. Methods：Randomized controlled trials（RCTs）in relevant databases：Cochrane Library,Pubmed,Web of Knowledge,Ebsco,Chinese Biomedical Literature,China National Knowledge Internet,Wanfang Data and VIP from 1900 to April 2013 were searched. Quality of the literature included was evaluated and data was extracted. Review Manager 5.0 software was used for Meta analysis. Results：Seven RCTs of 461patients were included in our study,230 patients in MECT plus SSRI group and 231 patients in SSRI group. Meta analysis results indicated that effective rate and curative rate of MECT plus SSRI group are better than those of SSRI group,with statistically differences（curative rate：Z=4.52,P=0.000;effective rate：Z=7.71,P=0.000）. In addition,incidence of recent memory disorders in MECT plus SSRI group was higher than that of SSRI group（P=0.013）. There was no difference in the rest of side effects between two groups（P ＆gt;0.05）. Conclusion：MECT plus SSRI is an effective and safety method in the treatment of refractory depression.

关 键 词：改良电休克 电休克 选择性5-羟色胺再摄取抑制剂 难治性抑郁症 META分析 

分 类 号：R749.054[医药卫生—神经病学与精神病学]