帕罗西汀配合高频重复经颅磁刺激对老年难治性抑郁症患者认知功能及MBP和NSE的影响

Influence of Paroxetine Combined with High Frequency Repetitive Transcranial Magnetic Stimulation on Cognitive Functions,MBP and NSE of Elderly Patients with Treatment-refractory Depression

目的观察帕罗西汀配合高频重复经颅磁刺激(rTMS)对老年难治性抑郁症(TRD)患者认知功能及髓鞘碱性蛋白(MBP)和神经元特异性烯醇化酶(NSE)的影响。方法选取我院收治的老年TRD患者102例作为研究对象,遵循随机、均等原则分为观察组和对照组。其中对照组给予帕罗西汀治疗,观察组在对照组基础上联合rTMS治疗。观察2组认知功能、心理状况、MBP和NSE浓度、不良反应发生率情况。结果 2组治疗2周、4周后认知功能评分均显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);治疗4周后2组HAMA、HAMD评分显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);治疗4周后2组MBP、NSE浓度水平显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);观察组不良反应发生率9.80%稍低于对照组11.76%(P>0.05)。结论帕罗西汀配合rTMS可有效改善老年TRD患者认知功能,缓解焦虑和抑郁状况,降低MBP和NSE浓度。

Objective To observe the influence of paroxetine combined with high frequency repetitive tran- scranial magnetic stimulation （rTMS） on cognitive functions, myelin basic protein （MBP） and neuron specific enzym （ NSE ） of elderly patients with treatment-refractory depression （TRD） . Methods One hundred and two cases of el- derly patients with TRD treated in our hospital were selected as the study objects, and were divided into the observation group and the control group according to random and equal principle. The control group was treated with paroxetine, and the observation group was treated with rTMS on the basis of the control group. Cognitive function, mental status, MBP and NSE concentrations, and incidence of adverse reactions were observed in the two groups. Results Cognitive func- tion scores after treatment of two and four weeks were significantly lower than those before treatment in the two groups （ P 〈 0.05 ）, which of the observation group were significantly lower than those of the control group （ P 〈 0.05 ） . Scores of HAMA and HAMD after treatment of four weeks were significantly lower than those before treatment in the two groups （ P〈0.05 ）, which of the observation group were significantly lower than those of the control group （ P〈0.05 ） . Lev- els of MBP and NSE after treatment of four weeks were significantly lower than those before treatment in the two groups （ P〈0.05 ）, which of the observation group were significantly lower than those of the control group （ P〈0.05 ） . The incidence of adverse reactions was 9.80 % in the observation group, slightly lower than that of 11.76 % in the control group （ P 〉 0.05 ） . Conclusion Paroxetine combined with rTMS can effectively improve cognitive function of elderly patients with TRD, relieve anxiety and depression, and reduce the concentration of MBP and NSE.