脑涨落图检测精神分裂症患者无抽搐电休克治疗前后脑内神经递质功能的研究

目的探讨首发精神分裂症患者的神经递质功能特点及无抽搐电休克治疗对患者的神经递质功能的影响。方法采用脑涨落图仪(EFG)检测首发精神分裂症患者无抽搐电休克(MECT)治疗前后脑内神经递质功能。选取符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的首发精神分裂症患者24例,MECT治疗8~12次。在首次治疗前半小时,首次治疗之后半小时及24小时、末次治疗后24小时采用EFG检测脑内γ-氨基丁酸(GABA)、谷氨酸(Glu)、5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA)、乙酰胆碱(Ach)六种神经递质的功率。在首次治疗前及疗程结束后24小时进行阳性与阴性症状量表(PANSS)测评。结果与治疗前比较,治疗后半小时患者的全部递质功率升高(P0.05),首次治疗与末次治疗后24小时,多巴胺功率降低(P0.05)。5-HT、Ach、NE、DA的功率与P分呈正相关(P0.05),GABA与G分、PANSS总评分呈负相关(P0.05),PANSS评分P分和PANSS总评分降低(P0.01)、G分降低(P0.05)。结论 MECT治疗能降低精神分裂症患者多巴胺功能。

Changes of encephalofluctuograph of neurotransmitters function in schizophrenia patients before and after MECT

Objective To detect the neurotransmitters function in schizophrenia patients before and after MECT by utilizing En-cephalofluctuograph（ EFG）and to explore the characteristics of neurotransmitter of schizophrenia as well as the influence of MECT on neurotransmitter of schizophrenia. Methods 24 patients are treated 8～12 times by MECT. Neurotransmitters function is detected by using EFG half an hour before the first treatment,half an hour and 24 hours after the first treatment,24 hours after the last treatment, and a comparison has been made about the difference of the detection results before and after the treatment. Positive and Negative Symptoms Scale（ PANSS）is used to score the result before the first treatment and 24 hours after a course of treatment finished,and then compare the difference of PANSS score. Results Comparison between the results before and after the treatment. All the neuro-transmitter power of the patients is significantly increased half an hour after the MECT treatment（P﹤0. 05）. The dopamine power is de-creased dramatically 24 hours before the initial treatment and after the last treatment（P﹤0. 05）. The power of 5-HT,Ach,NE and DA is positively correlated（P﹤0. 05）. GABA is negatively correlated to G-points and total points（P﹤0. 05）. P-points and the total scores of PANSS significantly fall（P﹤0. 01）and G-points also decease dramatically. Conclusion MECT can efficiently de-crease the dopamine function of schizophrenia patients. As a new tool for noninvasive detecting neurotransmitters function.