| 陈英,洪道先,郑孝振,等.氯胺酮联合无抽搐电休克在治疗难治性抑郁症中对血清脑源性神经营养因子和认知功能的影响[J].安徽医药,2017,21(6):1113-1116. |
| 氯胺酮联合无抽搐电休克在治疗难治性抑郁症中对血清脑源性神经营养因子和认知功能的影响 |
| Effects of ketamine combined with modified electroconvulsive therapy on serum brain derived neurotrophic factor and cognition in the treatment of refractory depression |
| 投稿时间：2016-09-28 |
| DOI： |
| 中文关键词: 氯胺酮 无抽搐电休克 难治性抑郁症 血清脑源性神经营养因子 认知功能 |
| 英文关键词: Ketamine MECT TRD BDNF Cognitive function |
| 基金项目:河南省科技攻关项目(142102310246) |
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| 中文摘要: |
| 目的 探讨以氯胺酮为麻醉剂,联合无抽搐电休克治疗(MECT)对难治性抑郁症病人血清脑源性神经营养因子和认知功能的影响。方法 将62例难治性抑郁症病人,按照入院时间顺序随机分成异丙酚组和氯胺酮组,每组31例。异丙酚组使用异丙酚为麻醉剂进行MECT治疗,氯胺酮组使用氯胺酮为麻醉剂进行MECT治疗。记录两组病人治疗前及治疗1~8次后的临床指标,制作并比较两组病人的汉密尔顿抑郁测量(HAMD),认知功能表包括威斯康星卡片分类(WCST)与汉诺塔(TOH)测验,以及血清脑源性神经营养因子(BDNF)浓度水平。结果 两组病人进行治疗2次后血清中BDNF无明显变化；在第4次治疗后氯胺酮组BDNF的水平较异丙酚组高(P<0.05)；在第8次治疗后,两组病人BDNF水平均有升高,其中氯胺酮组显著高于异丙酚组(P<0.05)；氯胺酮组病人WCST评分完成分类数高于异丙酚组,异丙酚组病人总错误数高于氯胺酮组(P<0.05)；TOH评分两组各项分类数据均差异无统计学意义(P>0.05)；进行治疗后两组病人HAMD评分值均有降低,氯胺酮组病人HAMD分值均低于异丙酚组(P<0.05)。结论 在MECT中使用氯胺酮为麻醉剂治疗难治性抑郁症病人可提高病人血清中BDNF浓度水平,快速降低病人HAMD评分,能有效提高病人认知功能,适合临床推广。 |
| 英文摘要: |
| Objective To investigate the influence of modified electroconvulsive therapy (MECT) used ketamine for anesthetic on BDNF and cognitive function of patients with TRD.Methods 62 cases with TRD in our hospital from June 2013 to June 2014 were selected and divided into diprivan group and ketamine group,with 31 cases in each group.Diprivan group used diprivan for anesthetic and ketamine group used ketamine for anesthetic.After treatment,the clinic index of the two groups before and 1-8 times were recorded .The HAMD,WCST,TOH and BDNF of the two groups were compared.Results Two groups of patients were treated 2 times after serum BDNF had no obvious change.After four treatment BDNF level of ketamine group was higher than propofol group (P<0.05);in the eighth patients in the two groups after treatment,BDNF levels were increased,which was significantly higher than that of propofol ketamine group (P<0.05);ketamine group patients completed the classification score higher than the number of propofol in WCST group,propofol group patients total error number was higher than the ketamine group (P<0.05);the TOH scores of the two groups of the classification data showed no significant difference (P>0.05);treatment after two groups of patients HAMD score was lower in ketamine group HAMD patients the scores were lower than the propofol group (P<0.05).Conclusion The application of MECT used ketamine for anesthetic can improve BDNF level,lower HAMD score,improve cognitive function,which is worthy of wide application. |
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