重复经颅磁刺激对食管癌伴发抑郁患者大脑组织微结构、血清瘦素水平及抑郁情绪的影响  

Effect of Repetitive Transcranial Magnetic Stimulation on Microstructure of Brain Tissue,Serum Leptin Levels and Depressed Mood in Patients of Esophageal Cancer with Depression

作　　者：樊雪峰 贾学军 闫相涛[2] FAN Xue-feng;JIA Xue-jun;YAN Xiang-tao(Department of Oncology and Hematology,Neihuang County People’s Hospital,Neihuang,China,456300;Department of Respiratory Medicine,Henan Cancer Hospital Zhengzhou,China,450000)

机构地区：[1]内黄县人民医院肿瘤血液科,河南内黄456300 [2]河南省肿瘤医院呼吸内科,河南郑州450000

出　　处：《食管疾病》2022年第2期148-151,共4页Journal of Esophageal Diseases

摘　　要：目的分析重复经颅磁刺激对食管癌伴发抑郁患者的治疗效果。方法选取我科2018年9月至2020年12月103例食管癌伴发抑郁患者作为研究对象,按照抽签的方式分为两组,均接受常规治疗并辅以心理指导,对照组51例给予口服帕罗西汀片治疗,观察组52例在对照组基础上增加重复经颅磁刺激治疗,对比两组患者大脑组织微结构、神经内分泌指标、抑郁情绪。结果干预后,两组患者双侧海马、左侧苍白球、双侧丘脑、右侧额中叶、双侧前扣带回、双侧颞上回皮层的各向异性分数(FA)值均升高,且观察组升高水平明显高于对照组(P<0.05);两组患者血清瘦素、多巴胺、5-羟色胺(5-HT)水平均升高,但观察组升高水平明显高于对照组,两组患者血清皮质醇含量均减少,但观察组减少水平更为明显,差异具有显著性(P<0.05);两组患者抑郁自评量表(SDS)评分、汉密尔顿抑郁量表(HAMD)评分均下降,且观察组SDS、HAMD评分较对照组明显降低(P<0.05)。结论常规治疗基础上增加重复经颅磁刺激治疗食管癌伴发抑郁患者的效果明显好于常规治疗,能够改善神经内分泌指标,修复大脑组织微结构,改善患者的抑郁情绪。Objective To analyze the therapeutic effect of repetitive transcranial magnetic stimulation on patients of esophageal cancer with depression.Methods 103 patients with esophageal cancer complicated with depression(MD)in our hospital were selected from September 2018 to December 2020,and divided randomly into two groups,both receiving conventional treatment and supplemented with psychological guidance.In control group,51 patients,were treated with paroxetine tablets;in observation group,52 patients,received paroxetine tablets and repeated transcranial magnetic stimulation(TMS)treatment.The brain tissue microstructure,neuroendocrine indicators,and depression were compared between the two groups.Results After intervention,the fractional anisotropy(FA)values of bilateral hippocampus,left globus pallidus,bilateral thalamus,right middle frontal lobe,bilateral anterior cingulate gyrus and bilateral superior temporal gyrus cortex in the two groups increased,and the level in the observation group was significantly higher than that in the control group(P<0.05).The levels of serum leptin,dopamine,and 5-hydroxytryptamine(5-HT)in the two groups increased,but the increased levels in the observation group were significantly higher than those in the control group(P<0.05).The serum cortisol decreased in both groups,but the decrease was more obvious in the observation group(P<0.05).The self-rating depression scale(SDS)scores and Hamilton depression scale(HAMD)scores of the two groups decreased,and the SDS and HAMD scores of the observation group were significantly lower than those of the control group(P<0.05).Conclusion On the basis of conventional treatment,the effect of repetitive transcranial magnetic stimulation in the treatment of patients with esophageal cancer with depression is significantly better than that of conventional treatment,which could improve neuroendocrine indexes,repair the microstructure of brain tissue,and improve the depression of patients.

关 键 词：重复经颅磁刺激 帕罗西汀 食管癌 抑郁 

分 类 号：R735.1[医药卫生—肿瘤]