氯胺酮联合丙泊酚麻醉的改良电休克治疗对超重抑郁症患者脂肪因子及临床结局的影响

Effect of modified electroconvulsive therapy with ketamine combined with propofol anesthesia on adipokines and clinical outcome in patients with overweight depression

目的探究氯胺酮联合丙泊酚麻醉的改良电休克治疗对超重抑郁症患者脂肪因子及临床结局的影响。方法选取2018年1月至2020年1月在本院进行治疗的超重抑郁症患者78例作为研究对象,根据药物的不同分为两组,各39例。对照组单纯应用丙泊酚麻醉,研究组应用氯胺酮联合丙泊酚的改良电休克治疗,比较两组治疗前和治疗后1、2、4、6次抑郁评分及脂肪因子变化(抵抗素、瘦素、脂联素)。结果治疗前,两组抑郁评分比较差异无统计学意义;治疗后1、2、4、6次,两组抑郁评分比较差异有统计学意义(P<0.05)。治疗前,两组抵抗素、瘦素、脂联素等脂肪因子比较差异无统计学意义;治疗后1、2、4、6次,两组瘦素、脂联素等脂肪因子比较差异无统计学意义;治疗后1、2、4次,两组抵抗素比较差异无统计学意义,治疗后6次,两组抵抗素比较差异有统计学意义(P<0.05)。结论氯胺酮联合丙泊酚麻醉的改良电休克治疗可缓解超重抑郁症患者抑郁症状,改善脂肪因子水平,值得临床推广应用。

Objective To investigate the effect of modified electroconvulsive therapy(ECT)with ketamine combined with propofol anesthesia on adipokines and clinical outcome in patients with overweight depression.Methods 78 patients with major depressive disorder who were treated in our hospital from January 2018 to January 2020 were selected as reseach subjects,they were divided into two groups according to different medicine,with 39 cases in each group.Propofol was used in the control group and Ketamine combined with propofol was used in the study group.Depression scores and changes in adipokines(resistin,leptin,adiponectin)before and after 1,2,4,and 6 times of treatment were compared between the two groups.Results There was no significant difference in depression scores between the two groups before treatment;there was significant difference in depression scores between the two groups after 1,2,4,and 6 times of treatment(P<0.05).Before treatment,there was no significant difference in resistin,leptin,adiponectin and other adipokines between the two groups;After 1,2,4,6 times of treatment,there was no significant difference in leptin,adiponectin and other adipokines between the two groups;There was no significant difference in resistin between the two groups 1,2 and 4 times after treatment,but there was significant difference in resistin between the two groups 6 times after treatment(P<0.05).Conclusion The modified ect of ketamine combined with propofol anesthesia can relieve the depressive symptoms and improve the level of adipokines in patients with overweight depression,which is worthy of clinical application.