草酸艾司西酞普兰片联合改良电休克治疗用于双相情感障碍抑郁发作患者的效果及对血清脑源性神经营养因子的影响  

Efficacy of Escitalopram Oxalate Tablets Combined with Modified Electroconvulsive Therapy in Patients with Bipolar Disorder and Depressive Episode and Its Effects on Serum Brain-Derived Neurotrophic Factor

作　　者：马会 李婷 MA Hui;LI Ting(Dept.of Psychiatry,Jining Psychiatric Hospital,Shandong Jining 272051,China;Dept.of Psychiatry,Laixi Municipal Hospital,Shandong Laixi 266600,China)

机构地区：[1]济宁市精神病防治院精神科,山东济宁272051 [2]莱西市市立医院精神一科,山东莱西266600

出　　处：《中国医院用药评价与分析》2021年第10期1199-1202,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：山东省医药卫生科技发展计划项目(No.2019WS149)。

摘　　要：目的:探讨草酸艾司西酞普兰片联合改良电休克治疗(modified electro-convulsive therapy,MECT)用于双相情感障碍抑郁发作患者的效果及对血清脑源性神经营养因子(BDNF)水平的影响。方法:本研究为前瞻性随机对照试验,研究开始时间为2019年3月,截止时间为2020年10月。纳入对象为济宁市精神病防治院收治的双相情感障碍抑郁发作患者114例。随机分组方法为应用Excel函数生成114个随机数,按患者入院顺序依次分配,奇、偶数分别设为对照组、研究组。在临床调研期间,脱漏、失访7例,实际完成研究107例,其中对照组53例,研究组54例。对照组患者采用MECT,研究组患者采用草酸艾司西酞普兰片联合MECT。于治疗前、治疗8周后采用汉密尔顿抑郁量表(hamilton depression scale,HAMD)17项版本评定两组患者抑郁状况,检测血清BDNF水平,通过连线测试(trail making test,TMT)评定认知功能,观察两组患者的疗效和不良反应发生情况。结果:研究组患者的总有效率为92.59%(50/54),明显高于对照组的71.70%(38/53),差异有统计学意义(P<0.05)。治疗后,两组患者HAMD-17评分与同组治疗前相比明显降低,且研究组患者较对照组明显更低,差异均有统计学意义(P<0.05)。治疗后,两组患者血清BDNF水平与同组治疗前相比明显升高,且研究组患者较对照组明显更高,差异均有统计学意义(P<0.05)。治疗后,两组患者TMT-A、TMT-B时间与治疗前相比明显缩短,且研究组患者较对照组明显更短,差异均有统计学意义(P<0.05)。两组患者头痛、恶心呕吐、头晕和短期记忆障碍等不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:草酸艾司西酞普兰片联合MECT用于双相情感障碍抑郁发作患者的疗效较为理想,可明显缓解患者抑郁状况,有效上调BDNF水平,显著改善认知功能,且治疗安全性相对较高。OBJECTIVE: To probe into the efficacy of Escitalopram oxalate tablets combined with modified electroconvulsive therapy(MECT) in patients with bipolar disorder and depressive episode and its effects on serum brain-derived neurotrophic factor( BDNF). METHODS: This study was a prospective randomized controlled trial,which started in Mar. 2019 and ended in Oct. 2020. A total of 114 patients with bipolar disorder and depressive episode admitted into Jining Psychiatric Hospital were extracted, and the sample size was determined by the sample size of the superiority test. Excel function was used to generate 114 random numbers, and patients were assigned according to the order of admission. Odd and even numbers were set as control group and study group respectively. During the clinical investigation, there were 7 cases of missed and lost follow-up, and 107 cases completed the experiment, including 53 cases in the control group and 54 cases in the study group. The control group was treated with MECT, while the study group received Escitalopram oxalate tablets combined with MECT. The depression status of two groups before treatment and after treatment of 8 weeks was evaluated by Hamilton Depression Scale-17(HAMD-17), and the serum BDNF level was detected, cognitive function was assessed by Trail Making Test(TMT), the efficacy was evaluated and the incidence of adverse drug reactions was analyzed. RESULTS: The total effective rate of the study group was 92. 59%(50/54), significantly higher than 71. 70%(38/53) of the control group, with statistically significant difference(P<0. 05). After treatment, the HAMD-17 score of two groups was significantly lower than that before treatment, and the HAMD-17 score of the study group as lower than that of the control group, with statistically significant difference(P<0. 05). After treatment, the serum BDNF level of two groups was significantly higher than that before treatment,and the serum BDNF level of the study group was significantly higher than that of the control group, with stati

关 键 词：草酸艾司西酞普兰片 改良电休克治疗 双相情感障碍抑郁发作 脑源性神经营养因子 

分 类 号：R971[医药卫生—药品]