美金刚辅助脑深部电刺激治疗青少年难治性强迫症的疗效及对血清神经因子和炎性细胞因子的影响OACSTPCD
Efficacy of memantine-assisted deep brain stimulation in adolescents with refractory obsessive-compulsive disorder and its effect on serum neurofactors and inflammatory cytokines
目的 探讨美金刚辅助脑深部电刺激治疗青少年难治性强迫症的疗效及对血清神经因子和炎性细胞因子的影响.方法 将115例青少年难治性强迫症患者随机分为对照组(57例)和研究组(58例).对照组采用舍曲林联合脑深部电刺激治疗,研究组采用美金刚联合脑深部电刺激治疗,持续治疗3个月.比较2组治疗效果、不良反应、血清神经因子、炎性细胞因子、精神状态、心理社会功能、生活质量的差异.其中,血清神经因子包括5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)、胶质细胞源性神经营养因子(GDNF);炎性细胞因子包括肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-2、IL-6;采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)评估精神状态;采用个体和社会功能量表中文版(PSP-CHN)评估心理社会功能;采用汤旦林生活质量量表(TDL-QOLAS)评估生活质量.结果 研究组的治疗总有效率高于对照组(分别为96.55%和84.21%,P＜0.05).治疗1个月、3个月后,研究组血清5-HT、BDNF水平高于对照组,血清GDNF、TNF-α、IL-2、IL-6水平低于对照组(P＜0.05);研究组HAMA、HAMD评分低于对照组,PSP-CHN、TDL-QOLAS评分高于对照组(P＜0.05).2组不良反应的发生率无统计学差异(P＞0.05).结论 美金刚辅助脑深部电刺激治疗青少年难治性强迫症疗效确切,可调节神经因子、炎性细胞因子水平,缓解焦虑和抑郁情绪,改善心理社会功能和生活质量,且安全性高.
Objective To explore the efficacy of memantine-assisted deep brain stimulation in adolescents with refractory obsessive-compulsive disorder and its effect on serum neurofactors and inflammatory cytokines.Methods A total of 115 adolescents with refractory obsessive-compulsive disorder were randomly divided into the control group(n = 57)and the study group(n = 58).The control group was treated with sertraline combined with deep brain stimulation for 3 months,while the study group was treated with memantine combined with deep brain stimulation for 3 months.The efficacy,adverse reactions,serum neurofactors(including 5-hydroxytryptamine[5-HT],brain-de-rived neurotrophic factor[BDNF],and glial neurotrophic factor[GDNF]),inflammatory cytokines(including tumor necrosis factor-α[TNF-α],interleukin[IL]-2,and IL-6),mental state,psychosocial functioning,and quality of life before and after treatment were compared between the two groups.Results The total effective rate in the study group was significantly higher than that in the control group(96.55%and 84.21%,P＜0.05).Compared with the control group,the serum 5-HT and BDNF levels at 1-and 3-month post-treatment were signifi-cantly higher in the study group,while the levels of serum GDNF,TNF-α,IL-2,and IL-6 were significantly lower(P＜0.05).The scores of Hamilton Anxiety Scale and Hamilton Depression Scale were significantly lower and the scores of Chinese Version of the Personal and Social Performance Scale,and TDL Quality of Life Assessment Scale were significantly higher in the study group than in the control group(P＜0.05).The incidence of adverse reactions between the two groups were similar(P＞0.05).Conclusion Our results support the efficacy of memantine-assisted deep brain stimulation for refractory obsessive-compulsive disorder in adolescents.In particular,the treatment can regulate neurofactor and inflammatory cytokine levels,relieve anxiety and depression,improved psychosocial function and quality of life,and is safe.
程德君;仲照希;原富强
新乡医学院第二附属医院 精神障碍科,河南 新乡 453002新乡医学院第二附属医院 心境障碍科,河南 新乡 453002新乡医学院第二附属医院 老年精神障碍科,河南 新乡 453002
临床医学
美金刚电刺激青少年难治性强迫症神经因子
memantineelectrical stimulationadolescentrefractory obsessive-compulsive disorderneurofactor
《中国医科大学学报》 2024 (002)
153-159 / 7
2022年度河南省医学科技攻关计划软科学项目(LHGJ20220636)
评论