舍曲林联合短波宽MECT对抑郁症患者的效果

Effect of sertraline combined with MECT with short-wave wide stimulation mode in patients with depression

目的 研究舍曲林联合短波宽无抽搐电休克(Modified Electric Convulsive Therapy,MECT)在抑郁症患者中的疗效。方法 选取2021年6月~2022年6月期间本院收治的200例抑郁症患者为研究对象,采用抽签法分为实验组和对照组,每组100例,对照组接受舍曲林治疗,实验组接受舍曲林联合MECT治疗,两组均治疗6周。比较两组治疗前1天(day,d)、治疗后1 d、1周、2周血清C反应蛋白(C-reactive protein,CRP)、脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)、白介素-1β(Interleukin-1 β,IL-1β);比较治疗前和治疗后第2、4、6周汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、临床疗效变化总体评价量表(Clinical global assessment of change in efficacy,CGI-GI)评分、副反应量表(Treatment Emergent Symptom Scale,TESS);根据治疗6周后HAMD减分率判定疗效,根据疗效将患者分为痊愈组、显效组、有效组、无效组,比较不同组血清CRP、BDNF、IL-1β变化幅度。结果 治疗后1 d,两组血清CRP、BDNF、IL-1β比较差异无统计学意义(P>0.05);治疗后1周、2周,实验组血清CRP、IL-1β水平均低于对照组,血清BDNF水平高于对照组,均有统计学意义(P<0.05);治疗后第2、4、6周,实验组HAMD评分、CGI-GI评分低于对照组,均有统计学意义(P<0.05);治疗后第2、4、6周,两组TESS评分比较差异无统计学意义(P>0.05);不同疗效组血清CRP、BDNF、IL-1β变化幅度比较,痊愈组>显效组>有效组>无效组(P<0.05)。结论 舍曲林联合短波宽MECT刺激模式治疗抑郁症的疗效优于单独用药,可能通过调节CRP、BDNF、IL-1β水平发挥作用,且上述细胞因子与治疗应答情况有关。

Objective To investigate the efficacy of sertraline in combination with a short wave width modified electroconvulsive(MECT)stimulation modality in patients with depression.Methods 200 patients with depression admitted to our hospital from June 2021 to June 2022 were selected as the study subjects and divided into experimental group and control group by lottery,with 100 cases in each group.The control group received sertraline treatment,and the experimental group received sertraline combined with MECT treatment.Both groups were treated for 6 weeks.The levels of serum C-reactive protein(CRP),brain-derived neurotrophic factor(BDNF)and interleukin-1 β(IL-1β)were compared between the two groups at 1 day before treatment and 1 day,1 week and 2 weeks after treatment.Hamilton depression scale(HAMD)and clinical global assessment of change in efficacy(CGI-GI)scores were compared before treatment and at 2,4 and 6 weeks after treatment,Treatment Emergency Symptom Scale(TESS).According to the HAMD score reduction rate after 6 weeks of treatment,the patients were divided into cure group,markedly effective group,effective group and ineffective group.The changes of serum CRP,BDNF and IL-1β in different groups were compared.Results There was no statistical difference between the two groups in serum CRP,BDNF and IL-1β 1day after treatment(P>0.05).The levels of serum CRP and IL-1β were lower and the level of serum BDNF was higher in the experimental group than in the control group at the 1st and 2nd week after treatment(P<0.05).At the 2nd,4th and 6th week after treatment,the scores of HAMD and CGI-GI in the experimental group were significantly lower than those in the control group(P<0.05).There was no statistically significant difference in TESS scores between the two groups at 2,4,and 6 weeks after treatment(P>0.05).The change of serum CRP,BDNF and IL-1β in different groups was:cured grou P>markedly effective grou P>effective grou P>ineffective group(P<0.05).Conclusion The efficacy of sertraline combined with short wavelength width MECT stimulation mode in the treatment of depression is superior to that of sertraline alone,which may play a role by regulating the levels of CRP,BDNF and IL-1β,and the above cytokines are related to the treatment response.