CAJ | 학술논문

目的：探讨无抽搐电休克治疗( MECT)对精神分裂症的效果和患者认知功能的影响。方法将符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的50例精神分裂症患者作为研究组，进行为期6周的MECT治疗；将50例在性别、年龄、病程、教育程度、诊断上相匹配的单纯药物治疗的患者作为对照组，在治疗前、治疗结束后1天和治疗后2周分别进行阳性与阴性症状量表( PANSS)、威斯康星卡片分类测验( WCST)和韦氏记忆测验( WMS)评定。结果治疗后1天和治疗后2周两组PANSS总评分和各项因子分均较治疗前低，差异有统计学意义( P<0.01)。治疗后1天和治疗后2周研究组WCST的错误应答数和持续性错误数项目得分比治疗前和同期对照组低(P<0.05)。治疗后研究组WMS的再认、图片和联想的项目得分比治疗前和同期对照组均低(P<0.05)。治疗后研究组理解项目得分比治疗前和同期对照组高(P<0.05)。结论合并MECT治疗能快速缓解急性期精神分裂症患者的阳性症状，对记忆可能有部分短暂而可逆的影响，而对执行功能有着不同程度的改善。
목적：탐토무추휵전휴극치료( MECT)대정신분렬증적효과화환자인지공능적영향。방법장부합《국제질병분류(제10판)》(ICD-10)정신분렬증진단표준적50례정신분렬증환자작위연구조，진행위기6주적MECT치료；장50례재성별、년령、병정、교육정도、진단상상필배적단순약물치료적환자작위대조조，재치료전、치료결속후1천화치료후2주분별진행양성여음성증상량표( PANSS)、위사강성잡편분류측험( WCST)화위씨기억측험( WMS)평정。결과치료후1천화치료후2주량조PANSS총평분화각항인자분균교치료전저，차이유통계학의의( P<0.01)。치료후1천화치료후2주연구조WCST적착오응답수화지속성착오수항목득분비치료전화동기대조조저(P<0.05)。치료후연구조WMS적재인、도편화련상적항목득분비치료전화동기대조조균저(P<0.05)。치료후연구조리해항목득분비치료전화동기대조조고(P<0.05)。결론합병MECT치료능쾌속완해급성기정신분렬증환자적양성증상，대기억가능유부분단잠이가역적영향，이대집행공능유착불동정도적개선。
Objective To explore the effects of modified electroconvulsive therapy ( MECT) on syndrome and cognitive function of patients with schizophreniac. Methods Selecting 50 cases of patients with schizophreniac treated by MECT as a study group, and other 50 cases with similar gender, age, course, educational level and diagnosis treated only by drugs as a control group. Every patient was assessed by Positive and Negative Syndrome Scale ( PANSS ) , Wisconsin Card Sorting Test ( WCST ) and Wechsler Memory Scale ( WMS) pre-treatment, post-treatment and 2 weeks after the treatment. The results of the two groups were then compared. Results <br> The scores of positive syndrome in PANSS post-treatment in the study group were decreased significantly than in the control group (P<0. 01). The scores of wrong responses and perseverative errors in WCST post-treatment and 2 weeks after the treatment in the study group were decreased dramatically than those were pre-treatment and in the control group in the same period(P<0. 05). The scores of recognition, picture and association in WMS after the treatment in the study group were decreased obviously than those were pre-treatment and in the control group in the same period(P<0. 05). There was no difference between two groups 2 weeks after the treatment(P>0. 05). Conclusion Combination of MECT can quickly relieve positive syndrome in patients with schizophreniac. Al-though there may be some transient and reversible effects on memory, MECT have various levels of improvement on the executive func-tions.