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改良电休克治疗后不同亚型谵妄的相关因素分析 被引量:11

The prognostic factors of post-ECT delirium and its subtypes
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摘要 目的 分析不同亚型改良电休克治疗后谵妄(post-ECT delirium,PECTD)患者的风险因素.方法 收集改良电休克治疗(modified electroconvulsive therapy,MECT)患者一般人口学资料及经MECT治疗的相关资料以及治疗前患者服药情况;采用单因素分析可能导致PECTD的相关因素,多因素Logistic回归分析发生不同亚型PECTD的相关因素.结果共收集335例MECT患者,158例(47.2%)未发生PECTD,177例(52.8%)发生PECTD,其中活动增多型PECTD 118例(66.7%),活动减少型PECTD 59例(33.3%).单因素分析显示,活动增多型PECTD患者与未发生PECTD患者比较,治疗前服用碳酸锂(16/31,x2=5.239)、苯二氮(艹卓)类药(30/75,Z=1 3.927)、抗精神病药(107/132,xz=12.214)及抗抑郁药(16/37,x2=4.470)差异有统计学意义(均P<0.05);Logistic分析显示仅碳酸锂进入回归方程(OR=2.058,P=0.016),与年龄≤60岁患者相比,年龄>60岁患者发生PECTD的风险显著增高(OR=3.884,P=0.014);首次治疗的患者较非首次治疗患者更易发生活动减少型PECTD(OR=4.891,P<0.01).结论活动增多型PECTD的危险因素为治疗前使用碳酸锂.年龄>60岁患者发生活动减少型PECTD的风险显著增加;而活动减少型PECTD与首次MECT显著相关. Objective To analyze the prognostic factors associated with each subtype of post-ECT delirium (PECTD).Methods Enrolled patients who received electroconvulsive therapy.Data collected included the demographic data,modified electroconvulsive therapy (MECT) treatment parameters and pre-MECT medications.Logistic regression analysis was used to examine the prognostic factors for hyperactive and hypoactive PECTD.Results 177 (52.8%) out of 335 patients enrolled in this study developed post-ECT delirium,118/177 (66.7%) were classified as hyperactive subtype and 59/177(33.3%)hypoactive subtype.Single factor analysis showed that,pre-ECT use of lithium (16/31,x2=5.239),benzodiazepines (30/75,Z=13.927),antipsychotic (107/132,x212.214) or antidepressants(16/37,x5=4.470)were significantly associated with hyperactive PECTD,but only pre-ECT lithium remained significant (OR=2.058,P=0.016) in logistic analysis.For active PECTD,logistic analysis showed that,comparing with younger age group,patients aged older than 60 years had a higher risk to develop hypoactive PECTD (OR=3.884,P=0.014),and those who received the first ECT had a higher risk to develop hypoactive PECTD (OR=4.891,P<0.01).Conclusions Pre-ECT lithium may be the prognostic factor for hyperactive PECTD,while the prognostic factors for hypoactive ECT include age greater than 60 years old and after first ECT treatment.
出处 《中华精神科杂志》 CAS CSCD 北大核心 2016年第5期312-316,共5页 Chinese Journal of Psychiatry
关键词 电掠厥疗法 谵妄 危险因素 Electroconvulsive therapy Delirium Risk factors
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