低频重复经颅磁刺激对青少年抑郁症患者认知功能和血清神经营养因子的影响

Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Cognitive Function and Serum Neurotrophic Factors in Adolescents with Depression

目的 探讨低频重复经颅磁刺激(rTMS)辅助治疗对青少年抑郁症的临床效果及护理对策。方法 选取河南省某三级甲等医院2020年7月至2022年6月接诊的86例青少年抑郁症患者,按随机数字表法分为观察组(43例)和对照组(43例),两组均口服抗抑郁症药物,观察组联合应用低频rTMS,治疗时间为6周。采用汉密尔顿抑郁量表-24(HAMD-24)、重复性成套神经心理状态测验(RBANS)和蒙特利尔认知评估量表(MoCA)分别进行抑郁症状和认知功能检测,采用酶联免疫吸附试验法检测神经营养因子,记录治疗期间不良反应。结果 与治疗前相比,两组HAMD-24评分在治疗3周和6周时均有降低,观察组两时间点评分较对照组更低,差异有统计学意义(P<0.05);治疗6周时,两组RBANS和MoCA评分有升高,血清脑源性神经营养因子和神经生长因子指标有升高,并且观察组患者认知功能量表评分和血清神经营养因子均高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率的差异无统计学意义(P>0.05)。结论 抗抑郁症药物联合低频rTMS治疗方式应用于青少年抑郁症,可减轻病情,改善认知功能和神经营养因子,临床安全性较好。

Objective To investigate the clinical effect and nursing strategy of low-frequency repetitive transcranial magnetic stimulation(rTMS)adjuvant therapy in adolescents with depression.Methods A total of 86 adolescents with depression were selected from a tertiary A hospital in Henan Province from July 2020 to June 2022,and were randomly divided into observation group(43 cases)and control group(43 cases)by random number table method.The two groups were given oral antidepressants,and the observation group was combined with low-frequency rTMS.The treatment lasted 8 weeks.Depressive symptom was assessed by Hamilton depression scale-24(HAMD-24),cognitive function was assessed by repeatable battery for the assessment of neuropsye hological status(RBANS)and Montreal cognitive assessment scale(MoCA),and serum neurotrophic factors were assessed by enzyme-linked immunosorbent assay.Adverse reactions were recorded during treatment.Results At 3 and 6 weeks of treatment,the scores of HAMD-24 were decreased in both groups,and the scores of HAMD-24 in the observation group were lower than those in the control group at two time points(P<0.05).At 6 weeks of treatment,the scores of RBANS and MoCA were increased in both groups,and serum levels of brain-derived neurotrophic factor and nerve growth factor were increased in both groups(P<0.05).The scores of cognitive function scale and serum levels of neurotrophic factor in the observation group were higher than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion The treatment of antidepressant drugs combined with low-frequency rTMS could effectively reduce the severity of adolescents with depression,improve cognitive function and serum neurotrophic factor,with good clinical safety.