无抽搐电休克对精神分裂症疗效的性别差异分析  

Analysis of the efficacy of modified electroconvulsive therapy in schizophrenia patients across different genders

作　　者：仁佳俊 李玉婷 王婷婷 冯双双 谢宏成 梁峻钒 张虹俐 林资圆 向波 刘可智 梁雪梅 REN Jiajun;LI Yuting;WANG Tingting;FENG Shuangshuang;XIE Hongcheng;LIANG Junfan;ZHANG Hongli;LIN Ziyuan;XIANG Bo;LIU Kezhi;LIANG Xuemei(Department of Psychosomatic Medicine,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院心身医学科,泸州646000 [2]西南医科大学 [3]自贡市精神卫生中心

出　　处：《中国神经精神疾病杂志》2025年第2期89-94,共6页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨无抽搐电休克治疗(modified electroconvulsive therapy,MECT)在精神分裂症患者不同性别间的疗效。方法2018年5月至2022年8月期间在泸州市精神卫生中心、自贡市精神卫生中心和宜宾市第四人民医院3家精神专科医院纳入481例精神分裂症患者。所有患者辅以MECT治疗,连续2周,共6次治疗。根据性别分组,比较两组患者治疗前后阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评分,以及治疗后UKU不良反应评定量表(udvalg for kliniske undersogelser,UKU)、胃肠道症状评定量表(gastrointestinal symptom rating scale,GSRS)的差异。结果质量控制后共463例患者进行后续分析,男性246例,女性217例。与治疗前相比,治疗后两组患者PANSS总分、PANSS各子量表得分均降低(P<0.001);组间减分率比较,男性患者阴性症状减分率高于女性(31.24%±30.24%vs.25.80%±33.96%,P<0.05),而在总分、阳性症状、一般精神病理减分率方面,两组差异无统计学意义(P>0.05)。不良反应比较,女性患者出现其他类型不良反应的频率较男性高(47.47%vs.37.80%,P<0.05),而在精神、神经、自主神经及胃肠道不良反应方面,组间未见统计学差异(P>0.05)。相关分析显示,男性患者PANSS总分减分率与吸烟史(r=0.135,P=0.034)、饮酒史(r=0.160,P=0.012)呈正相关,女性患者PANSS总分减分率与病程呈负相关(r=-0.210,P=0.002),与起病年龄呈正相关(r=0.145,P=0.032)。结论MECT对精神分裂症男女性患者均具有显著疗效。与女性患者相比,MECT对男性患者的阴性症状疗效更为显著。此外,不同性别间MECT疗效的相关因素不同,需要综合考虑患者的临床特征以选择MECT方案。Objective To Investigate the efficacy of modified electroconvulsive therapy(MECT)in patients with schizophrenia across different genders.Methods From May 2018 to August 2022,481 patients with schizophrenia were recruited from three psychiatric hospitals in Luzhou,Zigong,and Yibin.According to gender grouping,both groups received adjunctive MECT treatment for two consecutive weeks for a total of six treatments.The differences in positive and negative syndrome scale(PANSS)scores before and after treatment,UKU adverse reaction rating scale(UKU),and gastrointestinal symptom rating scale(GSRS)scores were compared between the two groups.Results After quality control,463 cases were followed up for analysis including 246 males and 217 females.Compared with pre-treatment,the total PANSS score and scores on each subscale were significantly reduced in both genders after treatment(P<0.001).When comparing the reduction rates between the groups,the male patients showed a higher reduction rate in negative symptoms than the female patients(31.24%±30.24%vs.25.80%±33.96%,P<0.05).However,there were no significant differences between the two groups in the reduction rates of the total score,positive symptoms,and general psychopathology(P>0.05).The comparison of adverse reactions showed that the frequency of other types of adverse reactions was higher in female patients than in male patients(47.47%vs.37.80%,P<0.05).However,no significant differences were observed in the adverse reactions related to the mental,neurological,autonomic nervous system,and gastrointestinal systems(P>0.05).Correlation analysis revealed that the reduction rate of the PANSS total score was positively correlated with smoking history(r=0.135,P=0.034)and alcohol history(r=0.160,P=0.012)in male patients,while the reduction rate of the PANSS total score was negatively correlated with the disease duration(r=-0.210,P=0.002)and positively correlated with the age of onset(r=0.145,P=0.032)in female patients.Conclusion MECT is significantly effective for both male and

关 键 词：精神分裂症 无抽搐电休克治疗 性别差异 不良反应 PANSS 相关性分析 疗效 影响因素 

分 类 号：R749.3[医药卫生—神经病学与精神病学]