抗抑郁药物联合短期无抽搐电休克治疗对抑郁症疗效及认知功能的影响

Treatment of major depression with short-term MECT in addition to antidepressants: its effects on clinical efficacy and cognitive function

目的:探讨抗抑郁药物联合短期无抽搐电休克(MECT)治疗重性抑郁症对其急性期及远期临床疗效及认知功能的影响。方法:将重性抑郁症患者共132例分为试验组(58例)与对照组(74例),试验组采用抗抑郁药和短期无抽搐电休克治疗,对照组仅采用抗抑郁药物治疗。急性期分别观察患者在治疗第1天、第1周末、第2周末、第3周末的汉密尔顿抑郁量表(HAMD)和韦氏记忆量表(WMS)评分结果,用副反应量表(TESS)来评估治疗总的副反应情况,同时记录患者住院天数。随访期分别观察患者在治疗第6月末和第12月末的HAMD和WMS量表结果,并记录患者的复发率。结果:试验组在第2周末和第3周末的HAMD评分要好于对照组(P<0.05),且两组TESS总分比较无统计学差异。试验组住院天数要明显少于对照组(P<0.05)。WMS评分上试验组在第3周时要差于对照组(P<0.05),但在第6月末和第12月末的比较无统计学差异。试验组在第12月内的复发率要低于对照组(P<0.05)。结论:在足量抗抑郁药治疗的同时联合短期MECT治疗,是一种行之有效的治疗方案,既能迅速彻底地改善抑郁症患者的临床症状,减少患者住院天数及远期复发风险,又能避免MECT治疗次数过多导致的认知功能损害问题。

AIM：To investigate effects of the acute and long-term clinical efficacy and cognitive function by using short-term modified electroconvulsive therapy （MECT） in addition to antidepressants for the treatment of major depression.METHODS：132 patients of major depression were divided into two groups：the control group （74 cases） and the experimental group （58 cases）.Two groups were treated with antidepressants and antidepressants with short-term MECT.All patients were assessed on the first day of hospitalization,at the end of 1 st week,2nd week,34 week of hospitalization,after half year,and after one year based on Scale for the Hamilton depression scale （HAMD） and Wechsler Memory Scale （WMS）.The adverse effects and the length of hospital stay in acute phase were assessed using treatment-emergent symptom scale （TESS）.RESULTS：At the end of 2nd week and 3rd week of hospitalization,there was significant difference （P 〈 0.05） in HAMD but no significant difference （P 〉 0.05） in TESS scores between the experimental group and the control group.WMS score in the experimental group was worse than the control group at the end of 3rd week of hospitalization.However,there was significant difference （P 〈 0.05） in WMS after half year and one year.The recurrence rate of the experimental group was lower than that of the control group at the end of 12 months.CONCLUSION：Using adequate antidepressants with shortterm MECT during outbreak of major depression helped to improve the long-dated negative symptoms and cognitive function.Adequate antidepressants combined with short-term MECT is an effective treatment program,which can help to improve the depressive symptoms promptly and thoroughly,and reduce the length of hospital stay in acute phase and long-term risk of recurrence rate,but also to avoid cognitive impairment of MECT due to too many times of MECT.