MECT联合第二代抗精神病药治疗精神分裂症的疗效及其对血清神经递质和免疫功能的影响  

Efficacy of MECT combined with second-generation antipsychotics in the treatment of schizophrenia and its effect on serum neurotransmitter and immune function

作　　者：韩鹏飞[1] 陈长浩 沈子童[1] 孙莉[1] 张华峰 HAN Peng-fei;CHEN Chang-hao;SHEN Zi-tong;SUN Li;ZHANG Hua-feng(Department of Psychiatry,the Second People's Hospital of Suzhou,Suzhou 234000,Anhui,China;MECT Room,the Second People's Hospital of Suzhou,Suzhou 234000,Anhui,China)

机构地区：[1]宿州市第二人民医院精神科,安徽宿州234000 [2]宿州市第二人民医院改良电休克室,安徽宿州234000

出　　处：《川北医学院学报》2021年第6期714-718,共5页Journal of North Sichuan Medical College

基　　金：蚌埠医学院自然科学类项目(BYKY2019291ZD)。

摘　　要：目的:探讨改良电休克(MECT)联合第二代抗精神病药治疗精神分裂症的疗效及其对血清神经递质和免疫功能的影响。方法:将120例精神分裂症患者分为观察组和对照组,每组各60例。观察组采用MECT联合奥氮平治疗,对照组采用奥氮平治疗。比较两组治疗前后的认知功能、PANSS评分及临床疗效;检测两组治疗前后血清神经递质多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)及免疫功能指标CD3^(+)、CD4^(+)、CD8^(+)水平和CD4^(+)/CD8^(+)比值。统计两组治疗过程中不良反应的发生情况。结果:治疗前,两组认知功能言语智商、操作智商和PANSS评分比较,差异无统计学意义(P>0.05);治疗后,两组言语智商和操作智商评分均较治疗前增加,且观察组高于对照组(P<0.05),PANSS评分降低,且观察组低于对照组(P<0.05)。治疗后,观察组总有效率为81.67%,高于对照组的65.00%(P<0.05)。治疗前,两组DA、NE、5-HT水平比较,差异无统计学意义(P>0.05);治疗后,两组DA、NE、5-HT水平均升高,且观察组高于对照组(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+)水平比较,差异无统计学意义(P>0.05);治疗后,两组CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平升高(P<0.05),CD8^(+)水平下降(P<0.05)。观察组和对照组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:相比单纯药物治疗精神分裂症,MECT联合奥氮平疗效更加显著,且能有效调节血清神经递质水平,改善免疫功能,安全性较好。Objective:To investigate the efficacy of MECT combined with second-generation antipsychotics in the treatment of schizophrenia and its effect on serum neurotransmitter and immune function.Methods:120 schizophrenic patients were selected as study subjects and randomly divided into observation group(n=60,MECT combined with olanzapine treatment)and control group(n=60,olanzapine treatment).Cognitive function,PANSS score and clinical efficacy were compared between the two groups before and after treatment.Serum levels of neurotransmitter dopamine(DA),norepinephrine(NE),5-hydroxytryptopine(5-HT)and immune function indicators CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)ratio were measured before and after treatment in the two groups.The incidence of adverse reactions in two groups was statistically analyzed.Results:Before treatment,there was no significant difference in cognitive function,verbal IQ,operational IQ and PANSS scores between the two groups(P>0.05).After treatment,verbal IQ and operational IQ scores of the two groups were significantly increased,the observation group was higher than the control group(P<0.05),PANSS score significantly decreased,and the observation group was lower than the control group(P<0.05).The total effective rate after treatment was 81.67%in the observation group,which was higher than 65.00%in the control group(P<0.05).After treatment,DA,NE and 5-HT levels in the two groups were significantly increased,and the observation group was significantly higher than the control group(P<0.05).Before treatment,there was no significant difference in the levels of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)between the two groups(P>0.05).After treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were increased,while the levels of CD8^(+)were decreased(P<0.05).There was no significant difference in the total incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion:Compared with drug therapy alone for schizophrenia,MECT combined with olanz

关 键 词：精神分裂症 改良电休克 奥氮平 神经递质 免疫功能 

分 类 号：R74[医药卫生—神经病学与精神病学] R749.3[医药卫生—临床医学]