度洛西汀联合重复经颅磁刺激治疗老年抑郁障碍患者的效果及对脑源性神经营养因子水平的影响  

Effect of Duloxetine combined with repetitive transcranial magnetic stimulation in the treatment of elderly patients with depressive disorder and its influence on the level of brain-derived neurotrophic factor

作　　者：高晓 周田田[1] 刘珊[2] 郑占杰[3] GAO Xiao;ZHOU Tian-tian;LIU Shan;ZHENG Zhan-jie(Deparment of Geriatric Ward,Qingdao Mental Health Center,Shandong Province,Qingdao266034,China;Department of Special Inspection,Qingdao Mental Health Center,Shandong Province,Qingdao266034,China;Deparment of Open Ward,Qingdao Mental Health Center,Shandong Province,Qingdao266034,China)

机构地区：[1]青岛市精神卫生中心老年病房,山东青岛266034 [2]青岛市精神卫生中心特检科,山东青岛266034 [3]青岛市精神卫生中心开放病房,山东青岛266034

出　　处：《中国当代医药》2021年第28期96-99,共4页China Modern Medicine

基　　金：山东省青岛市医药科研指导计划项目(2014-WJZD153)。

摘　　要：目的探讨度洛西汀联合重复经颅磁刺激(rTMS)治疗老年抑郁障碍患者的治疗效果以及对血清脑神经营养因子(BDNF)表达水平的影响。方法选取2016年12月至2017年8月在青岛市精神卫生中心住院的60例老年抑郁症患者,采用随机数字表法分为真刺激组和伪刺激组,每组各30例。真刺激组采用度洛西汀联合rTMS治疗,伪刺激组采用度洛西汀联合rTMS伪刺激治疗。比较并分析两组患者治疗前、治疗8周末的汉密尔顿抑郁量表(HAMD-17)及可重复神经心理状态测验量表(RBANS)评分;并于入院第2天和治疗8周末清晨抽取空腹血标本,检测血清BDNF水平。结果在治疗8周末,两组患者的HAMD-17评分低于治疗前,真刺激组治疗8周末的HAMD-17评分低于伪刺激组,差异有统计学意义(P<0.05);两组患者治疗8周末的RBANS评分均高于治疗前,真刺激组治疗8周末的RBANS评分均高于伪刺激组,差异有统计学意义(P<0.05)。两组患者治疗8周末血样中的BDNF水平高于治疗前,真刺激组治疗8周末的血样中BDNF水平高于伪刺激组,差异有统计学意义(P<0.05)。结论度洛西汀联合rTMS能有效改善老年抑郁障碍患者的抑郁症状及认知功能。Objective To investigate the therapeutic effect of Duloxetine combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of elderly patients with depressive disorder and its influence on the expression of serum brain neurotrophic factor(BDNF).Methods A total of 60 elderly depressive patients in Qingdao Mental Health Center were selected from December 2016 to August 2017.All patients were divided into the true stimulation group and the pseudo stimulation group according to random number table methods,30 cases in each group.Patients in the true stimulation group were treated with Duloxetine and combined with rTMS,while patients in the pseudo stimulation group were treated with Duloxetine and combined with rTMS pseudo stimulation.The 17-item Hamilton depression rating scale(HAMD-17)and the repeatable battery for the assessment of neuropsychological status(RBANS)were compared and analyzed before treatment and 8 weeks after treatment.Fasting blood samples were taken on the second day of admission and the morning of the 8th weekend of treatment to detect the level of serum BDNF.Results At the end of 8 weeks of treatment,the HAMD-17 scores of the two groups were lower than those before treatment,and the HAMD-17 score of the true stimulation group was lower than that of the pseudo stimulation group at the end of 8 weeks of treatment,the differences were statistically significant(P<0.05).The RBANS scores of the two groups at the end of 8 weeks of treatment were higher than those before treatment,and the RBANS scores of the real stimulation group at the end of 8 weeks of treatment were higher than those of the pseudo stimulation group,the differences were statistically significant (P<0.05). The levels of BDNF in blood samples of the two groups at the end of 8 weeks of treatment were higher than those before treatment, and the level of BDNF in blood samples of the real stimulation group at the end of 8 weeks of treatment was higher than that of the pseudo stimulation group, the differences were statist

关 键 词：度洛西汀 重复经颅磁刺激 抑郁症 脑神经营养因子 认知功能 

分 类 号：R749.16[医药卫生—神经病学与精神病学]