不同波宽刺激下无抽搐电休克治疗重度抑郁症患者疗效及对认知功能的影响

Efficacy of modified electroconvulsive therapy in different wave widths and its impact on cognitive function in treating patients with major depression

目的观察不同波宽刺激下无抽搐电休克(MECT)治疗重度抑郁症患者的疗效及对认知功能的影响。方法重度抑郁症住院患者100例随机分为两组,每组50例。A组和B组波宽分别设置为1.0ms和0.5ms。比较两组治疗前后汉密尔顿抑郁量表17项(HAMD-17)评分、韦氏记忆量表中联想和再认评分、血清5-羟色胺(5-HT)和脑源性神经营养因子(BDNF)水平,并观察不良反应的发生情况。结果MECT治疗1、2周后,B组HAMD-17评分低于A组,减分率高于A组(P<0.05);B组治疗2周后联想和再认评分高于A组(P<0.05);B组治疗2周后血清5-HT和BDNF水平高于A组(P<0.05)。两组患者头晕头痛、恶心和胃部不适发生率比较差异无统计学意义(P>0.05);B组心律失常发生率高于A组(P<0.05)。结论MECT波宽设置为0.5ms时治疗重度抑郁症患者的疗效较好,可以有效改善患者认知功能,但易发生心律失常不良反应。

Objective To observe the efficacy of modified electroconvulsive therapy(MECT)with different wave widths and its impact on cognitive function in the treatment of the patients with major depression.Methods A total of 100 hospitalized patients with major depression were randomly divided into two groups with 50 cases each.During MECT,the wave width was set to 1.0 ms in group A and that was set to 0.5 ms in group B.The 17-item Hamilton depression scale(HAMD-17)score,association and recognition scores of Wechsler memory scale,and serum levels of 5-hydroxytryptamin(5-HT)and brain-derived neurotrophic factor(BDNF)were compared between the two groups before and after MECT treatment.The incidences of adverse reactions were oberserved.Results After MECT for one and two weeks,the reduction rate of HAMD-17 scores in group B was higher than that in group A(P<0.05).After treated for two weeks,both the association and recognition scores in group B were higher than those in group A(P<0.05).Additionally,serum 5-HT and BDNF levels in group B were higher than those in group A after MECT for two weeks(P<0.05).There were no statistically significant differences between the two groups in the incidences of dizziness,headache,nausea and gastric discomfort(P>0.05).However,the incidence of arrhythmia in group B was higher than that in group A(P<0.05).Conclusion In the treatment of the patients with major depression,MECT with a wave width of 0.5 ms has better efficacy in the improvement of cognitive function,but with a prone to produce arrhythmia.