无抽搐电痉挛治疗精神分裂症量效关系及早期预测

目的探讨无抽搐电痉挛治疗精神分裂症治疗数量与疗效的关系。方法 58例精神分裂症患者,接受无抽搐电痉挛治疗8次。采用阳性和阴性症状量表在治疗前、治疗4次、6次、8次结束时评估患者临床症状。规定第4次和第6次PANSS量表减分率≥45%为早期起效,治疗第8次末PANSS量表减分率≥65%为显著好转。结果患者治疗4次时有效率与治疗8次显好率显著相关(χ2=7.18,P=0.01),治疗6次时有效率与治疗8次显好率相关(χ2=5.18,P=0.02)。4次治疗无效的患者组中,6次有效率和8次显好率无关(χ2=0.58,P=0.45)。结论无抽搐电痉挛治疗精神分裂症疗效与治疗次数有关。治疗4次无效时,继续治疗效果无明显增加,建议换用其他治疗方案。

Relationship between MECT Times and Efficacy in the Treatment of Schizophrenia and Predictoin

Objective To investigate the relationship between MECT times and efficacy in the treatment of schizophrenia .Methods 58 schizophrenia patients received 8 times MECT.The positive and negative symptoms scale was used to evaluate clinical symptoms at the points of before treatment ,4 times,6 times and 8 times.Patients were divided into early -onset group and non early -onset group according 45%of PANSS reducing rate at point 4 and 6.The patients were divided into significant improvement group and non significant improvement group according 65%of PANSS reducing rate at point 8.Results Rate of early onset at points 4 and 6 had significant correlation with rate of significant improvement at points of 8（χ2 =7.18,P=0.01 andχ2 =5.18,P=0.02,respectively）.In the non early onset patients,there was no significant correlation between efficacy of point 6 and improvement at point 8（χ2 =0.58,P=0.45）.Conclusion There is correlation between treatment number and efficacy of MECT in the treatment of schizophrenia .It suggests that we should change other type of treatment if there is no response at point 4.