摘要
目的研究不同剂量奥氮平联合无抽搐电休克(Modified Electroconvulsive Therapy,MECT)治疗精神分裂症疗效的差异。方法选取我院2020年11月~2021年12月收治的142例精神分裂症患者纳入研究,按抽签法分为维持组、减量组,各71例。均行MECT治疗,两组在MECT治疗的基础上口服奥氮平治疗。分别于治疗前及治疗后记录两组阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)评分、蒙特利尔认知评估(Montreal Cognitive Assessment,MoCA)评分、副反应量表(Treatment Emergent Symptom Scale,TESS)评分,并比较两组血清脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)和中枢神经特异性蛋白(Central Nervous system Specific Proteinβ,S100β)水平。结果两组患者治疗后PANSS评分显著下降,减量组低于维持组(P<0.05);两组患者治疗后MoCA评分增加,减量组高于维持组(P<0.05);两组患者治疗后BDNF水平升高,减量组高于维持组,S100β水平下降,减量组低于维持组(P<0.05);两组患者治疗后TESS评分下降,减量组低于维持组(P<0.05)。结论在MECT治疗基础上,缓慢减少奥氮平剂量能够有效改善患者症状及认知功能,并且能够减轻脑损伤程度,恢复大脑功能,且安全性良好。
Objective To study the effects of different doses of olanzapine combined with modified electroconvulsive therapy(MECT)on in the treatment of schizophrenia.Methods A total of 142 schizophrenic patients admitted to our hospital from November 2020 to December 2021,and divide them into maintenance group and reduction group by lottery,with 71 cases in each group.All patients were treated with MECT,and the two groups were treated with olanzapine on the basis of MECT.The scores of positive and negative symptom scale(PANSS),Montreal Cognitive Assessment(MoCA)and Treatment Emergent Symptom Scale(TESS)were recorded,and the levels of brain-derived neurotrophic factor(BDNF)and central nervous system specific proteinβ(S100β)were compared between the two groups before and after the treatments.Results After treatment,the PANSS score of the two groups decreased significantly,which was lower in the reduction group than in the maintenance group(P<0.05).After treatment,the MoCA scores of the two groups increased,which was higher in the reduction group than in the maintenance group(P<0.05).After treatment,the level of BDNF in both groups increased,and the level of S100βin the reduction group was higher than that in the maintenance group,while that in the reduction group was lower than that in the maintenance group(P<0.05).TESS scores of the patients in the two groups decreased after treatment,and those in the reduction group were lower than those in the maintenance group(P<0.05).Conclusion Based on MECT treatment,slowly reducing the dose of olanzapine can effectively improve the symptoms and cognitive function of patients,and can reduce the degree of brain injury and restore brain function,with good safety.
作者
刘旭
胡晓辉
王群
王玲
部瑜
于振剑
LIU Xu;HU Xiaohui;WANG Qun(Kailuan Mental Health Center,Tangshan 063000,China)
出处
《国际精神病学杂志》
2025年第2期389-393,共5页
Journal Of International Psychiatry
基金
河北省医学科学研究课题计划(编号:20221569)。
关键词
奥氮平
无抽搐电休克
精神分裂症
脑源性神经营养因子
Olanzapine
Modified electroconvulsive therapy
Schizophrenia
Brain-derived neurotrophic factor
