| 阎加民,赵爱芹,王 莹,朱世丽,孙 建.舍曲林联合经颅磁刺激对青少年首发抑郁症认知功能的影响[J].,2021,(3):590-595 |
| 舍曲林联合经颅磁刺激对青少年首发抑郁症认知功能的影响 |
| The Effect of Sertraline Combined with Transcranial Magnetic Stimulation on the Cognitive Function of Adolescents with First-episode Depression |
| 投稿时间：2020-08-03 修订日期：2020-08-27 |
| DOI：10.13241/j.cnki.pmb.2021.03.041 |
| 中文关键词: 舍曲林 经颅磁刺激 青少年 首发抑郁症 microRNA-18a microRNA-124 认知功能 |
| 英文关键词: Sertraline Transcranial magnetic stimulation Adolescents First-episode depression microRNA-18a microRNA-124 Cognitive function |
| 基金项目:山东省自然科学计划项目（NO.ZR2016HL40） |
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| 中文摘要: |
| 摘要 目的：探讨舍曲林联合经颅磁刺激（TMS）对青少年首发抑郁症认知功能的影响。方法：选取2018年10月～2020年2月我院青少年首发抑郁症患者94例作为研究对象，简单随机化分为2组，各47例。对照组予以舍曲林治疗，观察组予以TMS联合舍曲林治疗，2组均连续治疗6周。比较2组疗效、不良反应发生率、随访12个月复发率及治疗前后血清微小核糖核酸（miR）-18a、miR-124水平、汉密尔顿抑郁量表(HAMD-17)评分、重复性成套神经心理状态测试（RBANS）中文版评分。结果：观察组总有效率（93.62%）高于对照组（78.72%），差异有统计学意义（P＜0.05）。治疗3、6周后观察组血清miR-18a、miR-124水平低于对照组（P＜0.05）。治疗3、6周后观察组焦虑/躯体化、睡眠障碍、抑郁迟滞及认知障碍评分低于对照组（P＜0.05）。治疗3、6周后观察组即刻记忆、言语功能、视觉广度、注意力及延时记忆评分高于对照组（P＜0.05）。2组不良反应发生率比较，差异无统计学意义（P＞0.05）。观察组随访12个月复发率低于对照组（P＜0.05）。结论：舍曲林联合TMS首次治疗青少年首发抑郁症，效果显著，能有效调节血清miR-18a、miR-124水平，减轻抑郁症状，从而提高认知功能，降低复发率，保证安全性。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of sertraline combined with transcranial magnetic stimulation (TMS) on the cognitive function of adolescents with first-episode depression. Methods: From October 2018 to February 2020, 94 patients with first-episode depression in our hospital were selected as the research object, and they were simply randomized into 2 groups, 47 cases in each. The control group was treated with sertraline, and the observation group was treated with TMS combined with sertraline. Both groups were treated continuously for 6 weeks. The efficacy, incidence of adverse reactions, recurrence rate after 12 months of follow-up, and serum microRNA (miR)-18a and miR-124 levels, Hamilton Depression Scale (HAMD-17) scores, and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Chinese version scores before and after treatment were compared between the two groups. Results: The total effective rate of the observation group (93.62%) was higher than that of the control group (78.72%), the difference was statistically significant (P<0.05). After 3 and 6 weeks of treatment, the levels of serum miR-18a and miR-124 in the observation group were lower than those in the control group (P<0.05). After 3 and 6 weeks of treatment, the scores of anxiety/somatization, sleep disorders, depression, and cognitive impairment in the observation group were lower than those in the control group (P<0.05). After 3 and 6 weeks of treatment, the scores of immediate memory, speech function, visual breadth, attention and delayed memory in the observation group were higher than those in the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the 2 groups (P>0.05). The recurrence rate of the observation group after 12 months of follow-up was lower than that of the control group (P<0.05). Conclusion: Sertraline combined with TMS is the first treatment for the first-episode depression in adolescents. It has a significant effect and can effectively regulate serum miR-18a and miR-124 levels, reduce the symptoms of depression, thereby improving cognitive function, reducing the recurrence rate, and ensuring safety. |
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