无抽搐电休克在首发抑郁障碍治疗中的应用价值及对脑结构的影响分析  

Analysis of the Application Value of Modified Electroconvulsive Therapy in the Treatment of First-episode Depression Disorder and Its Effect on Brain Structure

作　　者：林虹[1] 林伟成 谢友许[2] 邓晓苑 邹文锦[1] LIN Hong;LIN Weicheng;XIE Youxu;DENG Xiaoyuan;ZOU Wenjin(The Affiliated Brain Hospial of Guangzhou Medical University,Guangzhou 510370,China;不详)

机构地区：[1]广州医科大学附属脑科医院,广东广州510370 [2]广东省梅州市第三人民医院

出　　处：《中国医学创新》2022年第3期65-68,共4页Medical Innovation of China

基　　金：广东省梅州市社会发展科技计划项目(201126172051736)。

摘　　要：目的:探讨无抽搐电休克治疗(MECT)在首发抑郁障碍患者中的应用效果及对脑结构的影响。方法:将广州医科大学附属脑科医院和梅州市第三人民医院于2019年1月-2020年12月收治的60例首发抑郁障碍患者应用随机数字表法分为两组,每组30例。对照组接受药物治疗,观察组接受MECT治疗。对比两组治疗前后抑郁程度及血清脑源性神经营养因子(BDNF)水平变化情况,分析两组治疗前后磁共振脑结构变化情况。结果:治疗前,两组HAMD评分、WAIS-RC评分、BDNF水平和脑灰质体积(右侧顶叶中央后回、右侧额叶中央前回、左侧颞叶颞下回和左侧顶叶中央旁小叶)比较,差异均无统计学意义(P>0.05);治疗2周后,两组HAMD评分均显著下降,两组BDNF水平和脑灰质体积(右侧顶叶中央后回、右侧额叶中央前回、左侧颞叶颞下回和左侧顶叶中央旁小叶)均显著增大(P<0.05),且观察组各指标的变化幅度均明显大于对照组(P<0.05),而两组WAIS-RC评分比较,差异无统计学意义(P>0.05)。结论:MECT可有效改善首发抑郁障碍的临床症状及BDNF水平,同时可在一定程度上改善患者的脑结构。Objective:To investigate the effect of modified electroconvulsive therapy (MECT) in the treatment of first-episode depressive disorder and its effect on brain structure.Method:A total of 60 patients with first-episode depressive disorder treated in the Affiliated Brain Hospital of Guangzhou Medical University and the Third People’s Hospital of Meizhou City from January 2019 to December 2020 were divided into two groups according to the random number table method,with 30 patients in each group.The control group received drug treatment and the observation group received MECT treatment.The depression degree and serum BDNF level were compared between the two groups before and after treatment,and the changes of magnetic resonance brain structure were analyzed between the two groups before and after treatment.Result:Before treatment,there were no significant differences in HAMD score,WAIS-RC score,the level of BDNF,the gray matter volume (right central posterior parietal gyrus,right central anterior frontal gyrus,left inferior temporal gyrus and left paraparietal lobule) between two groups (P>0.05).After 2 week of treatment,the HAMD score of both groups decreased significantly,the level of BDNF and the gray matter volume (right central posterior parietal gyrus,right central anterior frontal gyrus,left inferior temporal gyrus and left paraparietal lobule) in both groups were increased significantly (P<0.05),and the change range of each index in the observation group were significantly greater than those in the control group (P<0.05),while there was no significant difference in the WAIS-RC score between two groups (P>0.05).Conclusion:MECT can effectively improve the clinical symptoms and BDNF level of first-episode depression disorder,and improve the brain structure of patients to a certain extent.

关 键 词：无抽搐电休克 首发抑郁障碍 脑结构 血清脑源性神经营养因子 

分 类 号：R749.4[医药卫生—神经病学与精神病学]