颅磁刺激治疗脑梗死后患者抑郁疗效及对5-HT和BDNF的影响

The effect of TMS on depression after cerebral infarction and its effect on serotonin and serum brain-derived neurotrophic factor

目的探讨颅磁刺激治疗脑梗死后抑郁疗效及对5-羟色胺(5-HT)和血清脑源性神经营养因子(BDNF)的影响。方法选取于2019年2月至2020年8月我院治疗脑梗死病人120例为观察对象,随机将其分为两组,对照组60例,接受常规药物治疗;研究组60例,在使用常规药物治疗的基础上联合颅磁刺激治疗。比较两组病人BI和HAMD评分、治疗有效率和NE、5-HT、BDNF水平,以及MoCA和MMSE分值。结果治疗后,两组病人BI评分高于治疗前,HAMD评分低于治疗前,研究组BI和HAMD评分均显著优于对照组,差异有统计学意义(P<0.05);对照组病人的治疗有效率(78.33%)较研究组治疗有效率(91.67%)低,差异有统计学意义(P<0.05);治疗前,两组病人NE、5-HT、BDNF水平比较,差异无统计学意义(P>0.05),治疗后两组NE、5-HT、BDNF水平均较治疗前升高,研究组各项水平均优于对照组,差异有统计学意义(P<0.05);治疗前,两组病人MoCA和MMSE分值比较,差异无统计学意义(P>0.05),治疗后,研究组MoCA和MMSE分值均比对照组高,差异有统计学意义(P<0.05)。结论颅磁刺激治疗脑梗死后抑郁症病人,对治疗有效率的提高具有显著影响,对认知能力的提升同样具有明显的作用,改善病人的不良情绪。值得推广和应用。

Objective To investigate the therapeutic effect of transcranial magnetic stimulation(TMS)on depression after cerebral infarction and its influence on serotonin and serum brain-derived neurotrophic factor(BDNF).Methods 120 patients with cerebral infarction treated in our hospital from February 2019 to August 2020 were selected as study subjects and randomly divided into two groups:the control group(60 patients),who received conventional drug therapy,and the study group(60 patients),who were treated with conventional drug therapy combined with TMS.BI and HAMD scores,treatment efficiency,NE,5-HT,BDNF levels,MoCA and MMSE scores were compared between the two groups.Results After treatment,BI score was higher than that before treatment,and HAMD score was lower than that before treatment.After treatment,BI and HAMD scores in the study group were significantly better than those in the control group,with statistically significant differences(P<0.05).The effective rate was 91.67%in the study group and 78.33%in the control group,which was significantly higher than that in the control group(P<0.05).Before treatment,the NE,5-ht and BDNF levels of the two groups were compared,and the difference was not statistically significant(P>0.05).After treatment,the levels of NE,5-HT and BDNF in the two groups were all higher than those before treatment,and the levels in the study group were all better than those in the control group,with statistically significant differences(P<0.05).Before treatment,MoCA and MMSE scores of the two groups were compared,and the difference was not statistically significant(P>0.05).After treatment,MoCA and MMSE scores of the study group were higher than those of the control group,and the difference was statistically significant(P<0.05).Conclusion TMS in the treatment of depression after cerebral infarction has a significant effect on the improvement of the effective rate of treatment,also has a significant effect on the improvement of cognitive ability,improve the patients’bad mood.It is worth popularizing and applying.