电抽搐治疗抑郁症时的脑电图变化及疗效对照研究

目的 研究电抽搐治疗抑郁症时即刻脑电图和疗后脑电图的变化,即刻脑电图与疗效间的关系.方法 将符合CCMD-3中抑郁发作诊断标准且有自杀倾向的42例病例随机分入电抽搐治疗组(简称A组)17例、无痉挛电抽搐组(简称B组)16例、电刺激组(简称C组)9例,分别施以不同电压,在通电后即进行脑电图(EEG)描记,并对电抽搐治疗组后24小时的EEG进行观察.疗效评价采用汉密尔顿抑郁量表(HAMD,17项)自杀项评分,于治疗前及第4次治疗后各评定一次.结果 (1)A、B两组均对控制自杀有效,无显著差异(P＞0.05),而C组无疗效.(2)A、B两组即刻EEG均呈现类全面性强直-阵挛发作(GTCS)样改变,C组无此变化.(3)A组疗后24小时EEG有异常之改变,但是可逆的.结论 (1)适当电压刺激诱发脑细胞异常放电,使EEG呈现类GTCS样改变是ECT获效之关键;(2)电抽搐治疗和无痉挛电抽搐治疗均可控制自杀,疗效相似;(3)ECT治疗EEG有轻度影响,呈可逆性变化.

The Control Study of EEG Changes and Curative Effects in Depressive Disorder Patients Who Accepted ECT

Objective To investigate the EEG Change of depressive disorder who accepted ECT and the relationship between instantly EEG and curative effect. Methods 42 depressive disorder padtients with suicide tendency were randomly assigned to three groups: 17 patients with ECT (A group), 16 patients accepted non-spasmus ECT(B group) and 9 patients with electric stimulation(C group). Different voltages were given to patients. We observed EEG at that time and 24 hours later. HAMD, especially the suicide item was used to evaluate the curative effect before therapy and four times later. Results (1)There was no significant between group A and group B (P>0.05). Suicide symptoms were significantly improved in group A and B, but not in group C. (2) EEG in group A and B showed GTCS wave form, but not in groupC. (3)Reversible changes of EEG were observed 24 hours later in group. Conclusions (1)Appropriate voltages cause paradoxical discharges of brain cells, and GTCS wave form of EEG is the key of therapy effect. (2)ECT and non-spasmus ECT all can lessen suicide symptoms and the curative effects were similar. (3)ECT can cause reversible changes of EEG.