无抽搐电休克辅助氨磺必利、阿立哌唑治疗对精神分裂症伴躁狂患者神经电生理指标及神经因子的影响

Effect of non-convulsive electroconvulsive therapy assisted with amisulpride and aripiprazole on neuroelectrophysiological indexes and neurotransmitters in patients with schizophrenia and mania

目的:探究无抽搐电休克疗法(Modified electroconvulsivetherapy,MECT)辅助氨磺必利、阿立哌唑治疗对精神分裂症(Schizophrenia,SCZ)伴躁狂患者阳性症状、神经电生理指标、神经因子的影响。方法:随机将我院2020年6月至2022年4月收治的98例SCZ伴躁狂患者分为对照组和研究组,各49例。对照组采用氨磺必利、阿立哌唑治疗,研究组基于对照组予以MECT治疗。治疗4 w,比较两组临床疗效及1 y复发率,采用阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)评估阳性症状、采用社会功能缺陷筛选量表(Social dysfunction screening scale,SDSS)评估社会功能缺陷程度;采用肌电诱发仪测定P300、N250、错误相关负电位(Error related negativity,ERN)、后正电位(Late positive potential,LPP)波幅;采用酶联免疫吸附法检测脑源性神经营养因子(Brain derived neurophic factor,BDNF)、神经生长因子(Nerve growth factor,NGF)、成纤维细胞生长因子2(Fibrobalst growth factor-2,FGF-2)水平。结果:研究组临床总有效率(95.92%)高于对照组(81.63%)(P<0.05);治疗后研究组阳性症状、SDSS评分低于对照组(P<0.05);治疗后研究组P300、N250、ERN波幅高于对照组,LPP波幅低于对照组(P<0.05);治疗后研究组BDNF、NGF高于对照组,FGF-2低于对照组(P<0.05);研究组1 y复发率(6.82%)低于对照组(23.26%)(P<0.05)。结论:MECT辅助氨磺必利与阿立哌唑治疗SCZ伴躁狂疗效显著,能促进神经功能恢复,有效改善阳性症状,利于社会功能恢复,且复发率较低。

Objective:To investigate the effects of modified electroconvulsive therapy(MECT)assisted with amisulpride and aripiprazole on positive symptoms,neuroelectrophysiological indicators,and neurotransmitters in patients with schizophrenia(SCZ)accompanied by mania.Methods:Using the random number table method,98 patients with SCZ accompanied by mania admitted to our hospital from June 2020 to April 2022 were divided into a reference group(49 cases)and a research group(49 cases).The control group was treated with amisulpride and aripiprazole,and the study group was treated with MECT based on the control group.After 4 weeks of treatment,the clinical efficacy and 1-year recurrence rate of the two groups were compared.Positive symptoms were assessed by Positive and Negative Syndrome Scale(PANSS),social dysfunction screening scale(SDSS)was used to assess the degree of social dysfunction;P300,N250,error-related negative potentials were measured by myoelectric evoked meter.The degree of social dysfunction was assessed by the Social dysfunction screening scale(SDSS);P300,N250,Error related negativity(ERN),and Late positive potential(LPP)wave amplitude were measured by electromyography;and Brain derived neurophic factor(BDNF)was detected by enzyme-linked immunosorbent assay(ELISA).Brain derived neurophic factor(BDNF),nerve growth factor(NGF),and fibroblast growth factor-2(FGF-2)were measured by enzyme-linked immunosorbent assay.Results:The total effective rate of the study group(95.92%)was higher than that of the reference group(81.63%)(P<0.05).After treatment,the scores of SAPS,SDSS and FIS in the study group were lower than those in the control group(P<0.05).After treatment,the amplitude of P300,N250 and ERN in the study group was higher than that in the reference group,and the amplitude of LPP was lower than that in the reference group(P<0.05).After treatment,BDNF and NGF in study group were higher than those in reference group,FGF-2 were lower than those in reference group(P<0.05).The 1-year recurrence rate was lower in the study group(6.82%)than in the control group(23.26%)(P<0.05).Conclusion:MECT-assisted amisulpride and aripiprazole have significant therapeutic effects in the treatment of SCZ with mania,promoting the recovery of neurological functions,effectively improving positive symptoms,facilitating the recovery of social functions,reducing feelings of inferiority,and having a low recurrence rate.