上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2018, Vol. 38 ›› Issue (1): 76-.doi: 10.3969/j.issn.1674-8115.2018.01.014

• 论著（临床研究） • 上一篇    下一篇

电抽搐治疗老年抑郁症随机对照研究的系统评价

苏亮1, 2，施慎逊1,2，陆峥1, 3，贾玉萍1，梁世桥1，徐一峰1   

  1. 1. 上海交通大学 医学院附属精神卫生中心临床五科，上海 200030；2. 复旦大学附属华山医院精神科，上海 200040；3. 同济大学附属同济医院
    心身科，上海 200065
  • 出版日期:2018-01-28 发布日期:2018-03-09
  • 通讯作者: 徐一峰，电子信箱：hyyyyb@gmail.com。
  • 作者简介:苏 亮（1978—），男，副主任医师，博士；电子信箱：lsu@fudan.edu.cn。
  • 基金资助:
    上海市级医院新兴前沿技术联合攻关项目（SHDC12012109）；上海市重性精神病重点实验室开放课题项目（13dz2260500）

Electroconvulsive treatment for geriatric depression: a systematic review of randomized clinical trials

SU Liang1, 2, SHI Shen-xun1, 2, LU Zheng1, 3, JIA Yu-ping1, LIANG Shi-qiao1, XU Yi-feng1   

  1. 1. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 2. Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai 200040, China; 3. Department of Psychiatry, Tongji Hospital, Tongji University, Shanghai 200065, China
  • Online:2018-01-28 Published:2018-03-09
  • Supported by:
    New Frontier Technology Joint Research Project of Shanghai Municipal Hospital, SHDC12012109; Open Project of Shanghai Key Laboratory of Psychotic Disorders, 13dz2260500

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摘要： 目的· 探讨电抽搐治疗老年抑郁症患者的临床疗效及安全性。方法· 检索PubMed、EMBase、Web of Knowledge、中国期刊
网、万方、维普及中国生物医学文献等数据库，以随机临床试验报告的声明为参照标准进行入组和评价文献，采用RevMan 和STATA
软件进行meta 分析。结果· 共有10 篇文献纳入系统评价，分别对使用汉密尔顿抑郁量表（HAMD，n=5）及蒙哥马利抑郁量表
（MADRS，n=3）的研究进行抑郁症状疗效的汇总分析。治疗前、后的样本量分别为306 例和290 例，结果显示无论使用何种抑郁症
状评估工具，老年抑郁症经过电抽搐治疗后，抑郁症状均显示有所改善（HAMD：Z=6.39，SMD=3.64，P=0.000；MADRS：Z=15.47，
SMD=2.12，P=0.000）。简易智力状况检查量表（MMSE）评分治疗前后差异无统计学意义（Z=1.47，P=0.140）。发生率大于5% 的不
良反应有头痛、意识模糊、嗜睡、恶心呕吐等。结论· 电抽搐治疗老年抑郁症患者后，其抑郁症状改善显著，整体认知功能损害不明
显，但易发生头痛、意识障碍等不良反应。

关键词: 电抽搐治疗, 老年, 抑郁, 随机对照研究, meta 分析

Abstract:

Objective · To explore the clinical effectiveness and safety of electroconvulsive therapy (ECT) in elderly patients with depression.
Methods · Searches were made in PubMed, EMBase, Web of Knowledge, CNKI, Wanfang, VIP, CBMDisc databases and etc. CONSORT (Consolidated
Standards of Reporting Trials) statement were used to assess the methodological quality of the studies. RevMan and STATA were used to do meta analysis.Results · Ten studies were included in this systematic review. The studies which used Hamilton depression rating scale (HAMD, n=5) and MontgomeryÅsberg depression rating scale (MADRS, n=3) to access depressed symptom were analyzed. Sample size was 306 and 290 before and after treatment, respectively. The depressive symptoms were significantly improved after ECT treatment estimated by either HAMD (Z=6.39, SMD=3.64, P=0.000) or MADRS (Z=15.47, SMD=2.12, P=0.000). There was no difference of Mini-mental State Examination (MMSE) scores before and after the treatment
(Z=1.47, P=0.140). The incidence of adverse events of headache, confusion, drowsiness, nausea and vomiting was more than 5%. Conclusion · Depressed
symptoms are significantly improved in geriatric depression after ECT. The overall cognitive impairment is not obvious, but headache and disturbance of
consciousness are common.

Key words: electroconvulsive therapy, elderly, depression, randomized controlled trial, meta analysis