【摘要】：目的探討以氯胺酮為麻醉劑的無(wú)抽搐電休克(MECT)治療難治性抑郁癥患者的療效及與腦源性神經(jīng)營(yíng)養(yǎng)因子(BDNF)含量變化的相關(guān)性。方法將60例難治性抑郁癥患者隨機(jī)分為氯胺酮組及丙泊酚組(各30例)分別使用氯胺酮、丙泊酚作為麻醉劑進(jìn)行MECT治療。所有患者在MECT治療前及治療1~8次后完成漢密爾頓抑郁量(HAMD)、認(rèn)知功能及不良反應(yīng)量表(TESS)評(píng)定,抽血測(cè)BDNF濃度。結(jié)果兩組在治療后HAMD總分均明顯下降(P0.01),而氯胺酮組在治療第1次開(kāi)始減分優(yōu)于丙泊酚組(P0.01);氯胺酮組從治療第4次開(kāi)始血清BDNF濃度明顯升高(P0.01),丙泊酚組治療前后無(wú)明顯變化;MECT治療后血清BDNF濃度與HAMD總分呈顯著負(fù)相關(guān)(r=-0.368,P0.01)。結(jié)論氯胺酮作為MECT麻醉劑治療難治性抑郁癥安全、有效,且患者BDNF水平隨抑郁程度好轉(zhuǎn)而升高。
[Abstract]:Objective to investigate the efficacy of non-convulsive electroconvulsive (MECT) with ketamine as anesthetic in the treatment of refractory depression and its correlation with the content of brain-derived neurotrophic factor (BDNF). Methods 60 patients with refractory depression were randomly divided into ketamine group (n = 30) and propofol group (n = 30). Ketamine and propofol were used as anesthetics for MECT. Before and after MECT treatment, all patients completed Hamilton depression (HAMD), cognitive function and adverse reaction scale (TESS) assessment, and blood samples were taken to measure the concentration of BDNF. Results after treatment, the total score of HAMD in ketamine group was significantly lower than that in propofol group (P 0.01), and the serum BDNF concentration in ketamine group was significantly higher than that in propofol group (P 0.01) from the 4th time of treatment, but there was no significant change in propofol group before and after treatment. There was a significant negative correlation between serum BDNF concentration and HAMD total score after MECT treatment (r 鈮，

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