【摘要】 目的比较西酞普兰合并改良电休克治疗(MECT)与西酞普兰单一治疗抑郁发作的效果以及对认知功能的影响。方法采取临床试验研究,收集符合《国际疾病分类第(10版)》(ICD-10)抑郁发作诊断标准的患者80例,随机分为西酞普兰合并MECT组及西酞普兰单药组各40例。合并MECT治疗组需进行为期2周、共8次MECT治疗。两组均经过为期4周的治疗。在MECT治疗前及治疗2、4周末采用汉密尔顿抑郁量表(HRSD)和威斯康星卡片分类测验(WCST)对两组疗效及认知损害进行测评。结果治疗前两组HRSD评分比较差异无统计学意义(t=0.51,P>0.05)。治疗2周末两组间HRSD评分差异有统计学意义(t=2.66,P<0.05);疗程结束时两组HRSD评分差异无统计学意义(t=1.81,P>0.05)。合并MECT组中WCST中的总应答数(ra)、完成分类(cc)、错误应答数(re)、概念化(rf%)、非持续错误(nrpe)及学习到学会(l-l%)等项在治疗2周后较治疗前差(P<0.05);在治疗4周后较治疗前好(P<0.05);其它各指标治疗前后差异均无统计学意义(P均>0.05)。结论西酞普兰合并MECT治疗较西酞普兰单药能更快起效,而且持续疗效稳定。合并MECT治疗患者可出现短期、可逆的认知功能损害,但提示远期预后较好。更多还原

【Abstract】 Objective To compare the clinical response and cognitive dysfunction of depressive inpatients treated with citapramil complicated with modified electro- convulsive therapy( MECT) and citapramil only. Methods According the clinical trial,80 inpatients matched with the criteria of International Classification of Diseases tenth edition( ICD- 10) about depressive disorder were enrolled,and divided randomly into both groups of citapramil complicated with MECT and citapramil only. After 8 times treatment of MECT and totally 4- week treatment,the response and cognitive dysfunction were compared at pre- and post- treatment of MECT for2 weeks and 4 weeks separately between the two groups with Hamilton Rating Scale for Depression( HRSD) and Wisconsin Card Sorting Test( WCST). Results At the baseline,the scores of HRSD were not different between both of groups( t = 0. 51,P > 0. 05).There was statistics difference between both of groups after 2- week treatment( t = 2. 66,P < 0. 05). In the group of complicated with MECT,scores of ra,cc,re,rf%,nrpe,and l- l% in WCST were decreased significantly after 2- week treatment,but improved after 4- week treatment and better than the baseline( t = 1. 81,P > 0. 05). Other items do not show the differences( P > 0. 05). Conclusion Citapramil with MECT can obtain the effects of treatment faster than with citapramil only,moreover,the effects can be maintained. The patients complicated with MECT will have a short- term,and reversible cognitive dysfunction.更多还原