不同频次无抽搐电休克治疗抑郁障碍患者疗效及对认知功能、fNRIS的影响  

Efficacy of different frequencies of modified electroconvulsive therapy in patients with depressive disorder and its effect on cognitive function and functional near infrared spectroscopy

作　　者：戴红[1] 祖鑫 郭伶俐 宋宝华[2] Dai Hong;Zu Xin;Guo Lingli;Song Baohua(Department of Psychiatry,The Third People's Hospital of Huzhou,Huzhou 313000,Zhejiang Province,China;Physical Therapy Center,The Third People's Hospital of Huzhou,Huzhou 313000,Zhejiang Province,China;Department of Psychosomatic Disorders,The Third People's Hospital of Huzhou Huzhou 313000,Zhejiang Province,China)

机构地区：[1]湖州市第三人民医院精神科,湖州313000 [2]湖州市第三人民医院物理治疗中心,湖州313000 [3]湖州市第三人民医院心身障碍科,湖州313000

出　　处：《中国基层医药》2024年第8期1133-1138,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省医药卫生科技计划(2020ky942);浙江省湖州市公益性应用研究项目(2022GYB48)。

摘　　要：目的:观察不同频次无抽搐电休克(MECT)治疗对抑郁障碍患者的疗效及认知功能、近红外脑功能成像(fNRIS)的影响。方法:回顾性选取2022年12月至2023年7月湖州市第三人民医院收治的抑郁障碍患者60例的临床资料,采用病例对照研究,根据治疗方式不同分为治疗1组、治疗2组与治疗3组,每组20例,三组患者均接受常规抗抑郁药物治疗,其中治疗1组在常规治疗基础上接受6次MECT治疗,治疗2组为8次MECT治疗,治疗3组为10次MECT治疗,三组患者治疗时间均为4周。比较三组患者治疗前后的汉密尔顿抑郁评分(HAMD-24)、汉密尔顿焦虑评分(HAMA-14)、临床疗效(CGI)评分、简易智力状态(MMSE)评分、威斯康星卡片分类测验(WCST)评分、连线测验A(TMTA)评分、连线测验B(TMTB)评分、数字符号转换测验(DSST)评分,统计患者治疗期间出现的不良反应,并采用副反应量表(TESS)评估药物不良反应发生情况;另外于治疗前后采用fNRIS在言语流畅性任务(VFT)下评估患者的认知功能。结果:治疗1周、2周及4周,治疗2组与治疗3组HAMD-24、HAMA-14及CGI评分均低于治疗1组,差异均有统计学意义(F组间=32.09,F时间=54.27,F交互=7.53,均P<0.05),(F组间=38.14,F时间=69.33,F交互=8.59,均P<0.05),(F组间=11.22,F时间=28.29,F交互=9.14,均P<0.05);治疗1组与治疗2组MMSE、WCST及DSST评分均高于治疗3组,TMTA、TMTB评分均低于治疗3组,差异均有统计学意义(F组间=14.20,F时间=44.27,F交互=6.24,均P<0.05),(F组间=18.23,F时间=67.15,F交互=8.54,均P<0.05),(F组间=9.30,F时间=75.16,F交互=9.41,均P<0.05),(F组间=19.47,F时间=85.76,F交互=9.33,均P<0.05),(F组间=22.26,F时间=46.37,F交互=6.52,均P<0.05)。三组不良反应发生率比较,差异无统计学意义(F组间=3.03,F时间=8.36,F交互=1.25,均P>0.05)。治疗4周后治疗2组患者VFT下组词个数及oxy-Hb水平均高于治疗1组与治疗3组,差异均有统计学意义(F=29.71,198.57,均P<0.05)。结论:MECT�Objective To investigate the efficacy of different frequencies of modified electroconvulsive therapy in patients with depressive disorder and its effect on cognitive function and functional near infrared spectroscopy.Methods The clinical data from 60 patients with depressive disorder,admitted to The Third People's Hospital of Huzhou between December 2022 and July 2023,were retrospectively analyzed.This study was designed as a case-control study.These patients were divided into three treatment groups according to different treatment methods:Group 1(n=20),Group 2(n=20),and Group 3(n=20).All patients underwent conventional antidepressant therapy.Additionally,Group 1 received six sessions of modified electroconvulsive therapy,Group 2 received eight sessions,and Group 3 received ten sessions.The treatment duration for all groups was 4 weeks.Comparisons were made among the three groups for pre-and post-treatment scores on the 24-item Hamilton Depression Rating Scale,14-item Hamilton Anxiety Rating Scale,Clinical Global Impression Scale,Mini-Mental State Examination,Wisconsin Card Sorting Test,Trail Making Test Part A(TMT-A),Trail Making Test Part B(TMT-B),and Digit Symbol Substitution Test.Furthermore,the incidence of adverse reactions during treatment was calculated,and the Treatment Emergent Symptom Scale was used to assess the occurrence of adverse drug reactions.Moreover,functional Near-Infrared Spectroscopy was used before and after treatment to evaluate the cognitive function of patients under the Verbal Fluency Task.Results At 1,2,and 4 weeks of treatment,the 24-item Hamilton Depression Rating Scale,14-item Hamilton Anxiety Rating Scale,and Clinical Global Impression Scale scores of Group 2 and Group 3 were significantly lower than those of Group 1(F inter-group=32.09,F time=54.27,F interaction=7.53,all P<0.05;F inter-group=38.14,F time=69.33,F interaction=8.59,all P<0.05;F inter-group=11.22,F time=28.29,F interaction=9.14,all P<0.05).The Mini-Mental State Examination,Wisconsin Card Sorting Test,and Digit Symbol

关 键 词：抑郁症 电休克 认知功能障碍 谱学 近红外线 疗效比较研究 药物相关性副作用和不良反应 

分 类 号：R749.4[医药卫生—神经病学与精神病学]