草酸艾司西酞普兰联合rTMS治疗血管性抑郁的疗效及对脑白质、炎症因子的影响  

Effect of escitalopram oxalate combined with rTMS in the treatment of vascular depression and its effect on white matter and inflammatory factors

作　　者：朱薇薇 蔡艳 方政华[2] 陈曦[3] ZHU Wei-wei;CAI Yan;FANG Zheng-hua(Department of Sleep Disorders,Hunan Brain Hospital,Changsha Hunan 410000,China;Department of Psychiatry,Hunan Brain Hospital,Changsha Hunan 410000,China)

机构地区：[1]湖南省脑科医院睡眠障碍科,湖南长沙410000 [2]湖南省脑科医院精神科,湖南长沙410000 [3]湖南省脑科医院少儿心理科,湖南长沙410000

出　　处：《临床和实验医学杂志》2023年第2期165-168,共4页Journal of Clinical and Experimental Medicine

基　　金：湖南创新型省份建设专项基金项目(编号:2019JJ50309);湖南省脑科医院2018年度院级科研计划课题项目(编号:2018A01)。

摘　　要：目的探讨草酸艾司西酞普兰联合重复经颅磁刺激(rTMS)治疗血管性抑郁的疗效及对脑白质、炎症因子的影响。方法回顾性分析2018年4月至2020年4月湖南省脑科医院收治的60例血管性抑郁患者,根据治疗方法不同分为观察组与对照组,每组各30例。观察组给予草酸艾司西酞普兰联合rTMS治疗,对照组仅给予草酸艾司西酞普兰治疗,均连续治疗8周。比较两组治疗后临床疗效与治疗前后心理状态变化、脑白质结构变化、血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平变化。结果观察组的临床治疗总有效率为93.33%,显著高于对照组(73.33%),差异有统计学意义(P<0.05)。治疗8周后,观察组的汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评分为(7.54±1.29)、(6.49±1.80)分,均显著低于对照组[(14.67±3.16)、(13.51±3.25)分],差异均有统计学意义(P<0.05)。观察组深部脑白质损害、脑室旁脑白质损害为(1.16±0.15)、(1.21±0.21)分,均显著低于对照组[(1.59±0.17)、(1.62±0.23)分],差异均有统计学意义(P<0.05)。观察组患者血清IL-6、TNF-α为(25.78±4.36)、(11.45±2.75)ng/L,均显著低于对照组[(37.65±4.44)ng/L、(19.36±3.86)ng/L],差异均有统计学意义(P<0.05)。结论草酸艾司西酞普兰联合rTMS治疗血管性抑郁疗效显著,能有效改善抑郁、焦虑等心理情绪,降低脑白质损害程度与血清炎症因子水平,值得临床推广。Objective To investigate the efficacy of escitalopram oxalate combined with repeated transcranial magnetic stimulation(rTMS)in the treatment of vascular depression and its effect on white matter and inflammatory factors.Methods A total of 60 patients with vascular depression admitted to Hunan Brain Hospital from April 2018 to April 2020 were retrospectively analyzed and divided into an observation group and a control group according to different treatment methods,with 30 patients in each group.The observation group was treated with escitalopram oxalate combined with rTMS,and the control group was treated with escitalopram oxalate only.After 8 weeks,the clinical efficacy and psychological status,white matter structure and serum inflammatory factor[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]levels were compared between the two groups after treatment.Results The overall response rate in the observation group was 93.33%,which was significantly higher than that in the control group(73.33%),the difference was statistically significant(P<0.05).The Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)in the observation group were(7.54±1.29),(6.49±1.80)points,which were significantly lower than those in the control group[(14.67±3.16),(13.51±3.25)points],the differences were statistically significant(P<0.05).The deep white matter damage and paraventricular white matter damage in the observation group were(1.16±0.15),(1.21±0.21)points,which were significantly lower than those in the control group[(1.59±0.17),(1.62±0.23)points],the differences were statistically significant(P<0.05).The serum IL-6 and TNF-αin the observation group were(25.78±4.36),(11.45±2.75)ng/L,which were significantly lower than those in the control group[(37.65±4.44),(19.36±3.86)ng/L],the differences were statistically significant(P<0.05).Conclusion Escitalopram oxalate combined with rTMS is effective in the treatment of vascular depression.It can effectively improve depression,anxiety and other psychological emotions,red

关 键 词：草酸艾司西酞普兰 重复经颅磁刺激 血管性抑郁 脑白质 炎症因子 

分 类 号：R749.4[医药卫生—神经病学与精神病学]