首发抑郁症患者药物治疗反应性与脑电图特征的相关性分析  

Correlation between medication responsiveness and EEG features in patients with first-episode depression

作　　者：邱洁 魏昌伟 石慧[2] 吴安石[1] Qiu Jie;Wei Changwei;Shi Hui;Wu Anshi(Department of Anesthesiology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院麻醉科,100020 [2]首都医科大学附属北京朝阳医院心理科,100020

出　　处：《北京医学》2025年第1期37-41,共5页Beijing Medical Journal

摘　　要：目的探讨首发抑郁症(first-episode depression,FED)患者药物治疗反应性与EEG特征的相关性。方法选取2020年10月至2022年5月首都医科大学附属北京朝阳医院心理科门诊的FED患者50例,根据抗抑郁药物治疗4周后患者汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分降低程度,将患者分为治疗有反应组(HAMD评分下降≥50%)与无反应组(HAMD评分下降<50%),收集患者一般资料和临床资料,比较治疗前后两组EEG特征,采用Spearman相关分析EEG变化特征与药物治疗反应性的相关性,采用多因素非条件logistic回归方程分析治疗后FED患者药物治疗反应性的影响因素。结果50例FED患者中男12例、女38例,年龄30~35岁,平均(31.5±6.6)岁。α波和θ波发生率分别为70.00%和64.00%,额颞棘波和额颞尖波发生率分别为62.00%和46.00%。两组性别、年龄、文化程度、甲状腺激素异常、心血管疾病的比较,差异均无统计学意义(P>0.05)。50例患者中,36例(72.00%)治疗后有反应。与治疗前相比,治疗后有反应组和无反应组HAMD评分均降低[(15.09±3.37)分比(35.62±5.41)分和(20.33±4.25)分比(36.05±5.28)分],α峰值频率(alpha peak frequency,APF)均降低[(8.78±1.53)Hz比(9.82±0.93)Hz和(6.21±1.67)Hz比(19.49±0.46)Hz],且治疗后有反应组HAMD低于无反应组,APF高于无反应组,差异均有统计学意义(P<0.05)。治疗后,与无反应组相比,有反应组α波和θ波发生率较低(5.56%比57.14%和11.11%比50.00%),额颞棘波和额颞尖波发生率较低(8.33%比50.00%和5.56%比35.71%),差异均有统计学意义(P<0.05)。Spearman相关分析结果显示,FED患者治疗有效性与广泛性慢波(α波和θ波)异常、14~20 Hz快波(额颞棘波和额颞尖波)异常呈负相关(P<0.05)。多因素回归分析结果显示,θ波异常(OR=1.069,95%CI:1.008~1.602,P=0.015)、额颞棘波异常(OR=1.085,95%CI:1.009~1.829,P=0.034)的FED患者更容易出现治疗后无反应。结论FED患者存在广泛性慢波Objective To explore the correlation between medication responsiveness and EEG features in patients with first-episode depression(FED).Methods A total of 50 patients with FED in the outpatient clinic of the Department of Psychiatry of Beijing Chaoyang Hospital,Capital Medical University from October 2020 to May 2022 were selected.According to the degree of reduction of patients'Hamilton depression scale(HAMD)scores after four weeks of antidepressant medication,patients were divided into the treatment responsive group(HAMD score decreased by≥50%)and the unresponsive group(HAMD score decreased by<50%),and general data and clinical data were collected.The general data and clinical data of the patients were collected,and the EEG characteristics of the two groups were compared before and after treatment.Spearman correlation was used to analyze the correlation between EEG changes and medication responsiveness,and multivariate unconditional logistic regression equation was used to analyze the influencing factors of medication responsiveness of FED patients after treatment.Results There were 12 males and 38 females among the 50 FED patients,aged from 30 to 35 years,with an average age of(31.5±6.6)years.The incidence of α wave and θ wave were 70.00% and 64.00% respectively,and the incidence of fronto-temporal spike waves and fronto-temporal sharp waves were 62.00% and 46.00% respectively.There were no significant differences in gender,age,education level,thyroid hormone abnormality and cardiovascular diseases between the two groups(P>0.05).Of the 50 patients,36 cases(72.00%)responded after treatment.Compared with before treatment,after treatment,the HAMD scores decreased[(15.09±3.37)points vs.(35.62±5.41)points and(20.33±4.25)points vs.(36.05±5.28)points],and alpha peak frequency(APF)decreased[(8.78±1.53)Hz vs.(9.82±0.93)Hz and(6.21±1.67)Hz vs.(19.49±0.46)Hz]in both responsive group and unresponsive group,and the differences were statistically significant(P<0.05).And the HAMD was lower but ADF was higher in t

关 键 词：首发抑郁症 脑电图特征 相关性 

分 类 号：R749.4[医药卫生—神经病学与精神病学]