改良电痉挛治疗对难治性抑郁症患者睡眠质量的影响研究

The effect of modified electroconvulsive therapy on sleep quality in patients with treatment-resistant depression

摘要:

目的 探究改良电痉挛治疗（MECT）对难治性抑郁症（TRD）患者睡眠质量的影响。方法 选取2024年6月—2025年6月绍兴市第七人民医院纳入的120例TRD患者作为研究对象，按信封抽签法随机分为对照组和MECT组，每组60例。对照组给予规范化抗抑郁药物治疗，MECT组在对照组的基础上给予MECT治疗，比较两组治疗后的临床疗效、抑郁情况、睡眠质量、5-羟色胺（5-HT）水平、脑源性神经营养因子（BDNF）水平、细胞因子水平及生活质量。结果 MECT组的治疗总有效率高于对照组（P <0.05）。MECT组治疗后的汉密尔顿抑郁量表（HAMD）、匹兹堡睡眠质量指数（PSQI）评分均低于对照组（P <0.05）；MECT组治疗前后HAMD、PSQI评分的差值均大于对照组（P < 0.05）。MECT组治疗后的5-HT、BDNF均高于对照组（P <0.05）；MECT组治疗前后5-HT、BDNF的差值均大于对照组（P <0.05）。MECT组治疗后的C反应蛋白（CRP）、白细胞介素-17（IL-17）、白细胞介素-8（IL-8）均低于对照组（P <0.05）；MECT组治疗前后CRP、IL-17、IL-8的差值均大于对照组（P <0.05）。MECT组治疗后的生活质量综合评定量表（GQOLI-74）评分高于对照组（P <0.05）；MECT组治疗前后GQOLI-74评分的差值均大于对照组（P <0.05）。结论 MECT治疗对TRD患者疗效及睡眠质量的影响较为显著。

Abstract:

Objective To evaluate the effect of modified electroconvulsive therapy (MECT) on sleep quality in patients with treatment-resistant depression (TRD).Methods From June 2024 to June 2025, 120 patients diagnosed with TRD were recruited and randomly allocated by the envelope method into a control group (n = 60) and an MECT group (n = 60). The control group was treated with standardized antidepressant medication, while the MECT group received MECT in addition to the same regimen. Post-treatment comparisons were made between the two groups with respect to overall clinical efficacy, severity of depressive symptoms, sleep quality, serum levels of 5-hydroxytryptamine (5-HT), brain-derived neurotrophic factor (BDNF) and inflammatory cytokines, and quality of life.Results The MECT group showed a higher overall effective rate than the control group (P < 0.05). After treatment, the scores of the Hamilton Depression Scale (HAMD) and Pittsburgh Sleep Quality Index (PSQI) in the MECT group were lower than those in the control group (P < 0.05). The differences in HAMD and PSQI scores before and after treatment in the MECT group were greater than those in the control group (P < 0.05). After treatment, the levels of 5-HT and BDNF in the MECT group were higher than those in the control group (P < 0.05). The differences in 5-HT and BDNF levels before and after treatment in the MECT group were greater than those in the control group (P < 0.05). After treatment, the levels of C-reactive protein (CRP), interleukin-17 (IL-17), and interleukin-8 (IL-8) in the MECT group were lower than those in the control group (P < 0.05). The differences in CRP, IL-17, and IL-8 levels before and after treatment in the MECT group were greater than those in the control group (P < 0.05). After treatment, the score of the Generic Quality of Life Inventory-74 (GQOLI-74) in the MECT group was higher than that in the control group (P < 0.05). The difference in GQOLI-74 scores before and after treatment in the MECT group was greater than that in the control group (P < 0.05).Conclusion MECT produces notable improvements in both therapeutic effectiveness and sleep quality among patients with TRD.