改良电抽搐治疗对精神分裂症和抑郁症患者淋巴细胞亚群的影响

Effect of MECT on lymphocyte subsets of patients with schizophrenia and patients with depression

目的探讨精神分裂症和抑郁症患者接受改良电抽搐治疗(MECT)后淋巴细胞亚群的变化。方法选择符合ICD-10诊断标准的精神分裂症患者32例,抑郁症患者27例。采用阳性和阴性症状量表(PANSS)和汉密尔顿抑郁量表17项版(HAMD-17)对治疗前后的精神分裂症患者和抑郁症患者症状严重程度进行评定。评价淋巴细胞亚群与PANSS和HAMD评分的相关性。结果 MECT治疗后30 min,精神分裂症患者CD4+明显下降,CD4+/CD8+明显下降。MECT疗程结束后,精神分裂症患者CD4+明显上升,CD8+明显下降,CD4+/CD8+明显上升,抑郁症患者CD8+明显下降,CD4+/CD8+明显上升,差异有统计学意义。相关性分析显示,精神分裂症患者CD4+与PANSS中阳性症状因子负相关。抑郁症患者CD4+/CD8+与HAMD中焦虑/躯体化因子负相关。结论经MECT治疗的精神分裂症和抑郁症患者免疫功能得到改变,精神症状有相应的改善,这可能是MECT治疗精神障碍的机理之一。

Objective To explore the change of lymphocyte subsets of patients with schizophrenia and depression after being administered by Modified electrical convulsive therapy（ MECT）. Methods 32 patients with schizophrenia and 27 patients with depression who met ICD- 10 diagnosis were selected to join the experiment. Positive and negative syndrome scale（ PANSS） and Hamilton Depression Scale（ HAMD- 17） were adopted to assess the severity of syndrome before and after treatment,while the correlations among lymphocyte subsets and scores of PANSS and HAMD were analyzed respectively. Results Levels of CD4＋and CD4＋/ CD8＋significantly decreased in patients with schizophrenia after 30- minutes treatment. Levels of CD8＋significantly decreased but that of CD4＋and the that of CD4＋/ CD8＋significantly increased in patients with schizophrenia after the end of treatment. Levels of CD8 ＋ significantly decreased and that of CD4 ＋ / CD8 ＋ significantly increased in patients with depression after the end of treatment,with all the differences statistically significant（ P〈0. 05）. There was negative correlation between CD4＋and scores positive syndrome factors of PANSS in patients with schizophrenia,and there＇s also negative correlation between CD4＋/ CD8＋and factor of anxiety / somatization symptom. Conclusion The immunologic function of patients with schizophrenia and depression have been improved after MECT,and their mental symptom have also been relieved. That may be one of the potential mechanisms of MECT treating mental disorder.