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目的 比较磁休克治疗（MST）与无抽搐电休克治疗（MECT）用于难治性抑郁症（TRD）的临床效果。方法 86例TRD患者按照治疗方法不同分为MST组（42例）和MECT组（44例），MST组采用MST,MECT组采用MECT，比较两组治疗前后汉密尔顿抑郁量表（HAMD）评分、蒙特利尔认知评估（MoCA）评分、定向恢复时间、住院时间及哥伦比亚电休克治疗主观副作用。结果 MST组治疗前后HAMD评分分别为（48.1±10.3）、（19.3±8.6）分，治疗前后MoCA评分分别为（21.3±3.5）、（24.0±3.1）分，治疗前后比较，P均<0.05;MECT组前后HAMD评分分别为（47.8±9.5）、（17.5±4.1）分，治疗前后MoCA评分分别为（20.1±3.8）、（22.5±3.2）分，治疗前后比较，P均<0.05；两组治疗后MoCA评分比较，P<0.05。MST组及MECT组定向恢复时间分别为（7.8±1.9）、（28.7±6.3）min，住院时间分别为（56.5±36.7）、（95.9±66.2）d，两组比较，P均<0.05。MST组发生短期记忆减退9例（21.4%）、头痛10例（23.8%）、肌肉疼痛6例（14.3%）、恶心或呕吐4例（9.5%）、其他4例（9.5%）,MECT组分别为31例（70.5%）、19例（43.2%）、21例（47.7%）、16例（36.4%）、9例（20.5%），两组短期记忆减退、肌肉疼痛、恶心或呕吐比例比较，P均<0.05。结论 MST与MECT用于TRD治疗具有同等抗抑郁疗效，但MST相较MECT有更好的认知功能保护，更快的术后恢复，更优的安全性特征，更短的住院时间。
Abstract：Objective To compare the clinical efficacy of magnetic seizure therapy(MST) and modified electroconvulsive therapy(MECT) in patients with treatment-resistant depression(TRD). Methods Eighty-six patients with TRD were divided into two groups based on the treatment modality: the MST group and the MECT group. Patients in the MST group received MST, while patients in the MECT group underwent MECT. The following indicators were compared before and after treatment: Hamilton Depression Rating Scale(HAMD) scores, Montreal Cognitive Assessment(MoCA) scores, reorientation time, length of hospitalization, and subjective side effects based on the Columbia electroconvulsive therapy(ECT) Side Effects Questionnaire. Results In the MST group before and after treatment, HAMD scores decreased from 48. 1 ± 10. 3 to 19. 3 ± 8. 6, and MoCA scores increased from 21. 3 ± 3. 5 to 24. 0 ± 3. 1(both P<0. 05). In the MECT group before and after treatment, HAMD scores decreased from 47. 8 ± 9. 5 to 17. 5 ± 4. 1, and MoCA scores increased from 20. 1 ± 3. 8 to 22. 5 ± 3. 2(both P<0. 05). After treatment, the MST group had significantly higher MoCA scores than the MECT group(P<0. 05). Reorientation time was significantly shorter in the MST group than in the MECT group [(7. 8 ± 1. 9) min vs.(28. 7 ± 6. 3) min, P<0. 05], and the length of hospitalization was also significantly shorter [(56. 5 ± 36. 7) days vs. 95. 9 ± 66. 2) days, P<0. 05]. In the MST group, there were 9 cases(21. 4%) of short-term memory loss, 10 cases(23. 8%) of headache, 6 cases(14. 3%) of muscle pain, 4 cases(9. 5%) of nausea or vomiting, and 4 cases(9. 5%) of other symptoms. In the MECT group, the corresponding numbers were 31(70. 5%), 19(43. 2%), 21(47. 7%), 16(36. 4%), and 9(20. 5%) cases. Significant differences were found in the short-term memory loss, muscle pain, and nausea or vomiting between the two groups(all P<0. 05). Conclusions MST and MECT demonstrate comparable antidepressant efficacy in the treatment of TRD. However, MST offers superior cognitive protection, faster postoperative recovery, better safety profile, and a shorter duration of hospitalization as compared with MECT.
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基本信息:
中图分类号:R749.4
引用信息:
[1]王玮,陈翠,陆艺,等.磁休克治疗与无抽搐电休克治疗用于难治性抑郁症的临床效果比较[J].山东医药,2025,65(07):1-5.
基金信息:
山东省医药卫生科技项目(202403090630); 山东省中医药科技项目(M2022199)
2025-07-25
2025-07-25