目的 探索重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)干预对青少年抑郁临床症状及血清炎症因子和脑神经因子的治疗作用.方法 分析笔者医院2022年5月1日至2023年5月30日期间诊治的青少年抑郁症患者110例,采用随机数字表法分为观察组(n=55)和对照组(n=55),对照组单一使用氟西汀治疗,观察组在对照组基础上加用rTMS刺激干预,治疗前和治疗后1.5和3.0个月后采用情绪智力量表(emotional intelligence scale,EIS)、世界卫生组织生存质量简表(World Health Organization quality of life bref,WHOQOL BREF)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)及对患者进行抑郁程度、情绪、认知功能障碍及生活质量进行评估.检测患者治疗后血清5-羟色胺(5-hydroxytryptamine,5-HT)、胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、白细胞介素(interleukin,IL)-1β、IL-6 和转化生长因子(transforming growth factor,TGF)-β1水平,并采用Western blot法检测外周血细胞IL-1β、IL-6和TGF-β1蛋白表达水平.结果 干预1.5、3.0个月后,两组EIS评分和WHOQOL-BREF各项评分均升高,且观察组高于对照组(P＜0.01),HAMD评分均降低,且观察组低于对照组,差异有统计学意义(P＜0.01).治疗后,观察组5-HT、BDNF、GFAP水平高于对照组,差异有统计学意义(P＜0.01).观察组TGF-β1水平高于对照组,而IL-6、IL-1β水平低于对照组(P＜0.01).结论 采用rTMS刺激对青少年抑郁症患者进行干预,患者抑郁症状程度减轻,情绪智力及生活质量得到进一步改善,rTMS治疗能够在基础药物治疗基础上进一步下调患者机体促炎因子(IL-1β、IL-6)和上调抗炎因子(TGF-β1)、脑神经因子(BDNF、GFAP、5-HT)表达,故采用rTMS刺激对青少年抑郁症进行治疗干预具备临床应用价值.
Effect of repetitive transcranial magnetic stimulation on inflammatory factors and cranial nerve factors in adolescent depression
Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)on the symptom treatment of adolescent depressed patients and the regulatory effect of serum inflammatory factors and cranial nerve factors.Methods A total of 110 adolescent patients with depression were analyzed from May 1,2022 to May 30,2023,including 55 in the observation group and 55 in the control group.emotional intelligence scale(EIS),the Hamilton depression scale(HAMD)and World Health Organization quality of life bref(WHOQOL BREF)were used to evaluate the emotional intelligence,depression and quality of life before treatment and 1.5 and 3.0 months after treatment.Serum 5-hydroxytryptamine(5-HT),glial fibrillary acidic protein(GFAP),brain-derived neurotrophic factor(BDNF),interleukin(IL)-1β,IL-6 and transforming growth factor(TGF)-β1 were detected,and the protein expression levels of IL-1β,IL-6 and TGF-β1 in peripheral blood cells were detected by Western blot.Results After 1.5 and 3.0 months of intervention,the EIS score and WHOQOL-BREF scores in were increased,and the observation group was higher than that of the control group(P＜0.01),and the HAMD score was lower than that of the control group(P＜0.01).After treatment,the levels of BDNF,5-HT and GFAP in the observation group were higher than those in the control group(P＜0.01).The levels of IL-1β and IL-6 were lower in the observation group,and the levels of TGF-β1 were higher(P＜0.01).Conclusion rTMS stimulation can further down-regulate the expression of pro-inflammatory factors(IL-1β,IL-6)and anti-inflammatory factors(TGF-β1)and cranial nerve factors(BDNF,GFAP,5-HT)in patients on the basis of basic drug treatment,so the use of rTMS stimulation in the treatment of adolescent depression has certain clinical application value.
Repetitive transcranial magnetic stimulationAdolescent depressionInflammatory factorsCranial nerve factors
万方数据
维普
