低剂量艾司氯胺酮复合丙泊酚用于抑郁症患者无抽搐电休克中的价值
The value of low dose esketamine combined with propofol in the treatment of modified electroconvulsive therapy in patients with depression
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| DOI |
| 刊名 |
Journal of International Psychiatry
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| 年，卷(期) |
2023, 50(6) |
| 作者 |
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| 作者单位 |
张家港市中医医院，麻醉科 ;
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| 摘要 |
【摘要】 探讨低剂量艾司氯胺酮复合丙泊酚用于抑郁症患者无抽搐电休克（Modified electroconvulsivetherapy ，MECT）中的价值。方法 选择2021年3月～2023年2月60例抑郁症患者为观察对象，按随机数字表法分为观察组（n＝30）与对照组（n＝30）。观察组在MECT中给予低剂量艾司氯胺酮复合丙泊酚麻醉，对照组给予等量生理盐水及丙泊酚麻醉，疗程共3周。记录两组治疗指标；治疗前及治疗结束后，通过威斯康星卡片分类测验（Wisconsin Card Sorting Test，WCST）评估两组认知功能，内容包括总应答数（responses answer，RA）、完成分类数（categories completed，CC）、正确应答数（correct response，RC）、持续性错误数（perseverative responses errors，RPE）；治疗前及治疗结束后，记录两组汉密尔顿抑郁量表（Hamilton Depression Scale，HAMD）评分并检测血清脑源性神经营养因子（brain-derived neurotrophic factor，BDNF）水平；记录两组不良反应。结果 观察组有效及缓解所需MECT次数、丙泊酚用量显著低于对照组（P＜0.05）。治疗后，观察组RA、RPE显著低于对照组，CC、RC显著高于对照组（P＜0.05）。治疗后，观察组HAMD评分显著低于对照组，BDNF显著高于对照组（P＜0.05）。两组不良反应发生率相当（P＞0.05）。结论 低剂量艾司氯胺酮复合丙泊酚可提高抑郁症患者MECT疗效，改善患者认知功能、抑郁情况及神经功能，且安全性较高。
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| Abstract |
【Abstract】Objective To investigate the value of low dose esketamine combined with propofol in the treatment of modified electroconvulsive therapy in patients with depression. Methods A total of 60 patients with depression from March 2021 to February 2023 were selected as the observation objects, and were divided into observation group (n = 30) and control group (n = 30) according to the random number table method. The observation group was given low dose esketamine combined with propofol in MECT, while the control group was given equal amount of normal saline and propofol. The course of treatment was 3 weeks. The treatment indexes of the two groups were recorded. The Wisconsin Card Sorting Test (WCST) was used to assess the cognitive function of the two groups before and after treatment, including responses answer (RA), categories completed (CC), correct response (RC), and perseverative responses errors (RPE). Hamilton Depression Scale (HAMD) scores and the level of serum brain-derived neurotrophic factor (BDNF) were recorded before and after treatment. Two groups of adverse reactions were recorded. Results The number of MECT required for effective and remission and the dosage of propofol in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, RA and RPE in observation group were significantly lower than those in control group, CC and RC were significantly higher than those in control group (P < 0.05). After treatment, HAMD score of observation group was significantly lower than that of control group, and BDNF was significantly higher than that of control group (P < 0.05). The incidence of adverse reactions was similar between the two groups (P > 0.05). Conclusions Low dose esketamine combined with propofol can improve the efficacy of MECT in patients with depression, improve cognitive function, depression and neurological function, and have high safety.
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| 关键词 |
【关键词】 抑郁症；无抽搐电休克；艾司氯胺酮；丙泊酚
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| KeyWord |
【Key words】 Depression; Modified electroconvulsive therapy; Esketamine; Propofol
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| 基金项目 |
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| 页码 |
1334-1337 |
钱衡*.
低剂量艾司氯胺酮复合丙泊酚用于抑郁症患者无抽搐电休克中的价值 [J].
国际精神病学杂志.
2023; 50; (6).
1334 - 1337.