无抽搐电休克治疗对精神分裂症事件相关电位的影响

目的观察多参数监护无抽搐电休克治疗（MECT）对精神分裂症事件相关电位（ERP）[P300潜伏期（P3-PL）、N2～P3峰峰波幅（N2-P3-Amp）、N2-P3峰峰潜伏期（N2-P3-PL）]的改变，探讨MECT对患者认知功能的影响，对临床症状的改变情况，进一步探讨MECT治疗精神病的机制。方法以36例MECT的精神分裂症患者为研究组（MECT组），36例同期住院相匹配的药物治疗精神分裂症患者为对照组。在治疗前及治疗1～2、4、8周均进行ERP检测。同时进行阳性与阴性症状量表（PANSS）评定疗效。结果MECT治疗1～2周P3-PL缩短、N2-P3-PL缩短、N2-P3-Amp增高与治疗前及对照组比较差异有统计学意义（P〈0．05或P〈0．01）；对照组P3-PL缩短在8周与治疗前比较差异有统计学意义（P〈0．05）；其余各项与治疗前比较无统计学意义（P〉0．05）。PANSS评分显示：MECT组临床疗效明显高于对照组（P〈0．05）；MECT组在治疗的第1～2周PANSS总分、精神病理分、阳性症状中的怪异行为、思维形式障碍分均较治疗前及对照组有显著下降（P〈0．05或P〈0．01）；而阳性症状中的幻觉、妄想和阴性症状在治疗早期无明显改变（P〉0．05）。结论MECT较早地改善精神分裂症认知功能；MECT较早地改善精神病理症状和阳性症状中的怪异行为、思维形式障碍，而阳性症状中的幻觉、妄想症状消失较晚且较难；阴性症状也较晚改善。

Objective To observe the multi - parameter monitoring of MECT influence on event - related potential （ ERP）,P300 incubation period（ p3 - PL）, peak - peak amplitude and latency of N2 - P3 （ N2 - P3 - Amp N2 - P3 - PL）. To explore MECT effect on cognitive function in patients, the change of clinic symptoms, and to explore the mechanism of MECT on schizophreniapatients. Methods 36 cases of patients with schizophrenia MECT for research, 36 patients was matched with drug therapy for patients with schizophrenia. Before the treatment and treatment of ERP l - 2.4.8 weeks. Simultaneously positive and negative symptoms scale PANSS group the efficacy. Results The treatment of 1 - 2 weeks MECT P3 - PL and N2 - P3 - PL shortened, N2 - P3 - Amp increase after treatment and difference was statistically significant （P 〈 0. 05 or P 〈 0. 01 ）. in the control group, the P3 - PL shortened in 8 weeks before treatment and the difference was statistically significant （ P 〈 0. 05 ） , the rest was various and treatment was statistically significant （P 〉 0. 05）. PANSS score showed MECT clinical curative effect were obviously higher than that of control group （P 〈 0. 05 ） ： in the treatment of MECT groups except negative symptoms factor of 1 - 2 weeks, and other factors points total control and was down significantly （ P 〈 0. 01 - 0.05 ） ; in the treatment of 1 - 2 weeks the positive symptoms strange behavior, thinking form in MECT group were significantly reduced compared with those before treatment and those of the control group （ P 〈 0. 05 ）, and for illusion, paranoia, no significant change （ P 〉 0. 05 ）. Conclusion MECT improves cognitive function in schizophrenia earlier; can help to the improvement of symptoms of depression and some positive symptoms earlier. The strange behavior, positive thinking form obstacles disappears but illusion and delusion disappeared later and more difficultly, Negative symptoms also improve later.