无抽搐电休克治疗精神分裂症时脑电活动与疗效的相关性分析

THE ANALYSIS OF THE CORRELATION BETWEEN BRAIN ELECTRICAL ACTIVITY AND CURATIVE EFFECT IN TREATING SCHIZOPHRENIA BY MODIFIED ELECTROCONVULSIVE THERAPY

目的探讨无抽搐电休克治疗(MECT)精神分裂症时脑电活动与疗效的关系。方法抽取24例经MECT的住院精神分裂症患者的病案资料,采用阳性与阴性症状量表(PANSS)评定行MECT前、后患者的临床症状改善程度,分析MECT时脑电活动的影响因素以及它们与疗效的关系。结果 1精神分裂症经MECT后有效率为91.67%。Spearman相关分析显示MECT时发作后抑制指数与病程呈负相关(P<0.05),与抽搐能量指数呈正相关(P<0.05);抽搐能量指数与发作后抑制指数呈正相关(P<0.01),与电量呈负相关(P<0.05);δ、θ、α和β波的幅度值与抽搐能量指数呈显著正相关(P<0.01),除δ外均与电量呈负相关(θ、βP<0.05;αP<0.01),而δ的波幅值也与发作后抑制指数呈显著正相关(P<0.01)。Spearman相关分析显示MECT前后PAN-SS减分率与各个发作波的波幅值及可能的影响因素的相关性均无统计学意义。结论 MECT对精神分裂症患者的疗效显著;MECT时脑电活动的影响因素主要是发作后抑制指数及电量等;脑电活动及其影响因素对疗效可能无影响。

Objective To investigate the relationship of brain electrical activity and curative effect on schizophrenia when treated with modified electroconvulsive therapy （MECT）. Methods The clinical data of 24 inpatients with schizophrenia treated with MECT were selected. The improvement of inpatients＇ clinical symptoms before and after MECT was assessed by the positive and negative syndrome scale （PANSS）. The influencing factors of brain eleetrica1 activity during the induced seizure and the relationship between the factors and the curative effect were analyzed. Results The curative rate of schizophrenia through MECT was 91.67%. Spearman correlation analysis implied that the postictal suppression indexes were negatively correlated with the course of disease but positively correlated with the energy index of tics during MECT（ P 〈0.01 ）. The energy index of tics was positively correlated with the postictal suppression indexes （ P 〈 0.01 ）but negatively correlated with the electric quantity（ P 〈 0. 05 ）. The amplitude values （δ, θ,α and β） were positively correlated with the energy index of tics（ P 〈0.01 ）, but negatively correlated with electric quantity（ θ, β： P 〈 0. 05 ;α： P 〈 0. 01 ）except the amplitude values of 8. There was a significantly positive correlation between the amplitude values of δ and the postictal suppression indexes（ P 〈 0.01 ）. Spearman correlation analysis showed that there was no statistical significance between the reduction fraction of I PANSS before and after MECT and the amplitude values of each waves as well as their possible influencing factors. Conclusion The curative effect of MECT on schizophrenia was obvious. The postictal suppression indexes and electric quantity were the main influencing factors of brain electrical activity during MECT, but the brain electrical activity and its influencing factors may not affect the efficacy on schizophrenia.