舍曲林联合重复经颅磁刺激对青少年强迫症患者血清IL-2、IL-6、BDNF浓度的影响

Effects of sertraline combined with repetitive transcranial magnetic stimulation on the serum level of IL-2,IL-6,and BDNF in adolescents with obsessive-compulsive disovders

目的探讨舍曲林联合重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对青少年强迫症(obsessive-compulsive disorder,OCD)患者血清白细胞介素-2(interleukin-2,IL-2)、IL-6和脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)的影响。方法选取住院治疗的青少年OCD患者76例为研究对象,随机分为观察组和对照组,每组38例,2组患者均口服舍曲林,观察组给予rTMS进行治疗,对照组给予rTMS伪刺激。治疗前及治疗4周、6周后采用耶鲁布朗强迫量表(Yale-Brown obsessive-compulsive scale,Y-BOCS)评定强迫症状;抽取治疗前及治疗6周后清晨空腹静脉血,测定血清IL-2、IL-6、BDNF浓度。结果观察组治疗4周、6周后Y-BOCS评分均显著低于同期对照组(P<0.05);观察组治疗6周后IL-6浓度显著低于对照组(P<0.05),治疗前后IL-6浓度差值与病情严重程度呈正相关(P<0.05),而IL-2、BDNF2组差异无统计学意义(P>0.05)。结论舍曲林联合rTMS治疗青少年OCD提高了抗强迫效应,其机制可能与有效调节血清细胞因子IL-6水平有关。

Objective To investigate the effects of sertraline combined with repetitive transcranial magnetic stimulation(rTMS)on the serum level of IL-2,IL-6,and BDNF in adolescents with obsessive-compulsive disovder(OCD).Methods A total of 76 adolescents with OCD who were treated in our hospital were randomly divided into observation group and control group,with 38 cases in each group.The patients in both groups were treated by oral sertraline,on that basis,the patients in observation group were treated by rTMS,however,the patients in control group were treated by sham rTMS.Before treatment and after 4-week and 6-week treatment,the Y-BOCS was used to evaluate the obsessive-compulsive symptoms,moreover the serum levels of IL-2,IL-6,and BDNF were observed and compared between the two groups.Results After 4-week and 6-week treatment,the Y-BOCS scores in observation group were significantly lower than those in control group(P<0.05).After 6-week treatment,the serum levels of IL-6 were significantly lower than those in control group(P<0.05).Before and after treatment,the IL-6 levels were positively correlated with the severity of the disease condition(P<0.05),however,there were no significant differences in the levels of IL-2 and BDNF between the two groups(P>0.05).Conclusion The sertraline combined with rTMS in treatment of DCD in adolescents can increase the anti-compulsive effects,and its action mechanism may be associated with the regulation of theserum levels of IL-6.