改良电休克治疗对双相障碍患者氧化应激水平的影响  

Effect of modified electroconvulsive treatment on oxidative stress parameters in patients with bipolar disorder

作　　者：吕钦谕[1] 鲍晨曦 任娟娟[1] 张晨[1] 程小燕 耿瑞杰 陆燕华 朱玉华 易正辉[1] 

机构地区：[1]上海交通大学医学院附属精神卫生中心,上海200030

出　　处：《上海交通大学学报（医学版）》2017年第10期1357-1361,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81671326);"精准医学研究"国家重点专项(2016YFC0906402);上海市精神卫生中心院级课题(2014-YJ-04;2015-YJGJ-03);上海交通大学文理交叉认知专项基金项目(16JXRZ06);上海市科学技术委员会科研计划项目(17411970000)~~

摘　　要：目的·探讨改良电休克治疗(MECT)对双相障碍患者氧化应激水平的影响。方法·选取双相障碍患者43例(患者组)行MECT 6周,同时选取健康人群49例作为正常对照组。患者组在治疗前、治疗6周末用汉密尔顿抑郁量表-17项(HAMD-17),Young躁狂评定量表(YMRS)和临床总体印象量表-严重程度(CGI-S)评估患者的疗效。并对2组外周血进行超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)含量检测,进行组间比较及治疗前后比较。结果·MECT治疗前双相障碍患者与正常人群比较,血浆MDA、GSH-Px水平较高,而SOD水平较低,CAT活性则无差异;与抑郁状态相比,MDA水平在躁狂状态更高,且其水平与CGI-S评分呈正相关。MECT治疗后CGI-S评分显著下降,血浆MDA水平在躁狂状态和抑郁状态均较治疗前明显下降,而其余氧化应激指标无变化。结论·双相障碍患者存在氧化应激损伤,不同疾病状态损伤程度不同;MECT改善疾病症状同时使血浆MDA水平下降,而对抗氧化指标则没有影响。Objective · To investigate the effect of modified electroconvulsive therapy （MECT） on oxidative stress parameters in patients with bipolar disorder. Methods · Forty-three patients with bipolar disorder （case group） were enrolled that received MECT intervention for 6 weeks, and 49 healthy volunteers （control group） were recruited. Chinese versions of the 17 items Hamilton Depression Rating Scale （HAMD-17）, Young Mania Rating Scale （YMRS） and Clinical Global Impression-Severity Scale （CGI-S） were used to assess the efficacy and side effects at baseline and after 6 weeks of treatment. The plasma levels of superoxide dismutase （SOD）, catalase （CAT）, glutathione peroxidase （GSH-Px） and malondialdehyde （MDA） were measured at baseline and after 6 weeks of treatment to assess the level of oxidative stress. Results · The serum MDA and GSH-Px levels of the case group were higher while the serum SOD levels of the case group was lower than that of the control group, and there was no significant difference in the serum CAT levels between two groups at baseline. MDA levels were higher in manic states than in depressed states, and they were positively correlated with the CGI-S scores. After MECT treatment, the CGI-S scores of patients decreased significantly, and the plasma MDA levels decreased significantly in manic and depressive states, but there was no change in other oxidative stress parameters. Conclusion · There was oxidative stress damage in patients with bipolar disorder, and the severity of the disease varied with the degree of damage. MECT improved the symptoms of the disease and decreased the level of plasma MDA, while there was no effect on the anti-oxidation index.

关 键 词：双相障碍 氧化应激 改良电休克治疗 

分 类 号：R749.4[医药卫生—神经病学与精神病学]