上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

合并改良电抽搐治疗对不同年龄首发精神分裂症患者认知功能的影响

许蔚倩1，齐钢桥1，陈兴阳1，齐文耀1，朱 新2，陈红英3，郭晓芸4   

  1. 1.浙江省台州市第二人民医院精神科， 台州 317200； 2.上海市虹口区精神卫生中心， 上海 200083； 3.上海交通大学BIO-X附属长宁区精神卫生中心， 上海 200042； 4.上海交通大学 医学院附属精神卫生中心， 上海 200030
  • 出版日期:2014-05-28 发布日期:2014-05-30
  • 通讯作者: 郭晓芸, 电子信箱: 406277842@qq.com。
  • 作者简介:许蔚倩（1979—）, 女， 主治医师， 学士; 电子信箱: zjttxwq@163.com。
  • 基金资助:

    国家自然科学基金（81201057）

Effects of combination of modified electroconvulsive therapy on cognitive function of first-episode schizophrenia of different ages

XU Wei-qian1, QI Gang-qiao1, CHEN Xing-yang1, QI Wen-yao1, ZHU Xin2, CHEN Hong-ying3, GUO Xiao-yun4   

  1. 1.Division of Psychiatry, the Second People's Hospital of Taizhou, Taizhou 317200, China; 2.Mental Health Center of Shanghai Hongkou District, Shanghai 200083， China; 3.Mental Health Center of Shanghai Changning District affiliated to BIO-X Center of Shanghai Jiao Tong University, Shanghai 200042, China; 4.Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Online:2014-05-28 Published:2014-05-30
  • Supported by:

    National Nature Science Foundation of China，81201057

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摘要：

目的 探讨单纯药物治疗及合并改良电抽搐治疗（MECT）治疗对首发精神分裂症患者精神病性症状及认知功能的影响。方法 选取住院治疗的首发精神分裂症患者104例，根据年龄分为低年龄组（18~26岁，n=52）和高年龄组（39~46岁，n=52），两组再根据治疗方法的不同分别分为单纯药物组和合并MECT组。对各组患者进行治疗前以及治疗后3、6、12周的阳性与阴性症状量表（PANSS）评分以及威斯康星卡片分类测验（WCST），并对其结果进行统计分析。结果 治疗3周后，低年龄层合并MECT组患者PANSS减分值显著高于单纯用药组，差异有统计学意义（P<0.001）；治疗3周和6周后，高年龄层合并MECT组PANSS减分值也显著高于单纯用药组，差异有统计学意义（P<0.001）。在治疗3周后的WCST测验中，低年龄层合并MECT组患者的完成应答数、正确应答数和完成分类数均明显高于单纯用药组，高年龄层合并MECT组患者的持续错误数明显低于单纯用药组，差异均有统计学意义（P<0.05）。结论 MECT能较快改善患者的精神病性症状，并能相应提高不同年龄患者的认知功能。

关键词: 改良电抽搐, 首发, 精神分裂症, 认知功能

Abstract:

Objective To investigate the effects of drug treatment alone or drug combined with modified electroconvulsive therapy (MECT) on psychotic symptoms and cognitive function of patients with schizophrenia. Methods One hundred and four inpatients with first-episode schizophrenia were divided into the low age group (age 18-26 years, n=52) and high age group (age 39-46 years, n=52) according to their ages. Each group was further divided into the drug treatment group and drug combined with MECT group based on the therapeutic method. The positive and negative syndrome scale (PANSS) score and Wisconsin card sorting test (WCST) were used to assess the psychotic symptoms and cognitive function for patients of each group before treatment and after 3, 6, and 12 weeks of treatment. The results were statistically analyzed. Results The reduction of PANSS scores of the drug combined with MECT group of low age group were significantly higher than those of the drug treatment group after three weeks of treatment. The difference was statistically significant (P<0.001). The reduction of PANSS scores of the drug combined with MECT group of high age group were significantly higher than those of the drug treatment group after three weeks and six weeks of treatment. The difference was statistically significant (P<0.001). The number of responses and correct responses and completed categories of WCST of the drug combined with MECT group of low age group were significantly higher than those of the drug treatment group after three weeks of treatment. The number of continuous errors of the drug combined with MECT group of high age group was significantly lower than those of the drug treatment group. The differences were statistically significant (P<0.05). Conclusion The MECT can rapidly improve the psychotic symptoms and increase the cognitive function of patients of different ages.

Key words: modified electroconvulsive therapy, first-episode, schizophrenia, cognitive function