西酞普兰联合无抽搐电休克治疗对BD抑郁发作患者PRL、TSH、Hcy水平的影响  

Effect of citalopram combined with non-convulsive electroconvulsive therapy on PRL,TSH and Hcy levels in patients with depressive episode of BD

作　　者：刘锡亮[1] 姜丽丽 王欣[1] 李钰 马密[1] LIU Xiliang;JIANG Lili;WANG Xin;LI Yu;MA Mi(Department of Special Examination,Qingdao Mental Health Center,Qingdao,Shandong 266000,China;Department of Nursing,Qingdao Central Hospital,University of Health and Rehabilitation Sciences,Qingdao,Shandong 266000,China)

机构地区：[1]青岛市精神卫生中心特检科,山东青岛266000 [2]康复大学青岛中心医院护理部,山东青岛266000

出　　处：《检验医学与临床》2024年第23期3567-3571,共5页Laboratory Medicine and Clinic

摘　　要：目的观察西酞普兰联合无抽搐电休克治疗对双相情感障碍(BD)抑郁发作患者催乳素(PRL)、促甲状腺激素(TSH)、同型半胱氨酸(Hcy)水平的影响。方法前瞻性选取青岛市精神卫生中心2021年8月至2023年2月收治的104例BD抑郁发作患者作为研究对象,采用随机数字表法将其分为药物组和联合组,每组52例。药物组单纯给予西酞普兰治疗,联合组采用无抽搐电休克治疗联合西酞普兰治疗。治疗前后评估两组24项汉密尔顿抑郁量表(HAMD24)、护士用自杀风险评估量表(NGASR)、阳性症状量表(SAPS)评分,检测两组Hcy、视网膜母细胞瘤结合蛋白4(RBBP4)、C反应蛋白(CRP)、内分泌激素相关指标[雌二醇(E_(2))、PRL]水平、甲状腺功能相关指标[TSH、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT4)、三碘甲状腺原氨酸(T_(3))]水平。统计并对比两组疗效及不良反应发生情况。结果治疗前,两组Hcy、RBBP4、CRP水平比较,差异均无统计学意义(P>0.05)。治疗后,两组Hcy、RBBP4、CRP水平低于治疗前,且联合组Hcy、RBBP4、CRP水平低于药物组,差异均有统计学意义(P<0.05)。治疗前,两组PRL、E_(2)、TSH、T_(3)、FT_(3)、FT4水平比较,差异均无统计学意义(P>0.05);治疗后,两组TSH、E_(2)水平高于治疗前,FT_(3)、FT4水平低于治疗前,且联合组E_(2)水平高于药物组,差异均有统计学意义(P<0.05)。治疗前,两组HAMD24、NGASR、SAPS评分比较,差异均无统计学意义(P>0.05);治疗后,两组HAMD24、NGASR、SAPS评分低于治疗前,且联合组HAMD24、NGASR、SAPS评分低于药物组,差异均有统计学意义(P<0.05)。联合组总有效率为90.38%,高于药物组的75.00%,差异有统计学意义(P<0.05)。两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论西酞普兰联合无抽搐电休克治疗可调节BD抑郁发作患者内分泌激素水平,降低Hcy、RBBP4、CRP水平,减轻抑郁症状,提高疗效。Objective To observe the effects of citalopram combined with convulsion-free electroconvulsive therapy on prolactin(PRL),thyroid-stimulating hormone(TSH)and homocysteine(Hcy)levels in patients with depressive episodes of bipolar disorder(BD).Methods Prospectively,104 patients with BD depressive episodes admitted to Qingdao Mental Health Center from August 2021 to February 2023 were selected and divided into drug group and combined group by the random number table method,52 cases in each group.The drug group was only treated with citalopram,and the combined group was treated with convulsion-free electroconvulsive therapy combined with citalopram.Before and after treatment,the 24-item Hamilton Depression Scale(HAMD24)score,Nurses′Global Assessment of Suicide Risk(NGASR)score,Scale for Assessment of Positive Symptoms(SAPS)score were evaluated;the Hcy,retinoblastoma-binding protein 4(RBBP4),C-reactive protein(CRP),endocrine hormone-related indexes[estradiol(E_(2)),PRL]levels,thyroid function related indicators[TSH,free triiodothyronine(FT_(3)),free thyroxine(FT 4),triiodothyronine(T_(3))]levels were detected.The effective rate and occurrence of adverse reactions in the two groups was assessed and compared.Results Before treatment,there were no significant differences in Hcy,RBBP4 and CRP levels between the two groups(P>0.05).After treatment,the levels of Hcy,RBBP4 and CRP in the two groups were lower than those before treatment,and the levels of Hcy,RBBP4 and CRP in the combined group were lower than those in the drug group,with statistically significant differences(P<0.05).Before treatment,there were no significant differences in the levels of PRL,E_(2),TSH,T_(3),FT_(3) and FT 4 between the two groups(P>0.05).After treatment,the levels of TSH and E_(2) were higher than those before treatment,FT_(3) and FT 4 levels were lower than those before treatment,and E_(2) level in the combined group was higher than that in the drug group,with statistically significant differences(P<0.05).Before treatment,there were no signi

关 键 词：西酞普兰 无抽搐电休克 双相情感障碍 抑郁发作 催乳素 促甲状腺激素 同型半胱氨酸 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R440[医药卫生—临床医学]