文章摘要
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)
作者单位E-mail
阎加民 淄博市妇幼保健院 山东 淄博 255000 nz235689@126.com 
赵爱芹 淄博市妇幼保健院 山东 淄博 255000  
王 莹 淄博市妇幼保健院 山东 淄博 255000  
朱世丽 淄博市妇幼保健院 山东 淄博 255000  
孙 建 淄博市妇幼保健院 山东 淄博 255000  
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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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