首發與復發抑郁癥患者記憶功能改善的比較

謝新鳳 鄧書祿 李詩燕 易蕓 楊晶雪 蘭寒菊

【摘 ?要】目的：比較計算機認知矯正治療對首發與復發性抑郁癥患者記憶功能的改善。方法：50例于2017年5月至2018年12月在廣西腦科醫院就診的抑郁癥急性發作期的患者按發病次數分為首發組與復發組，兩組患者均接受藥物草酸艾司西酞普蘭+計算機認知矯正治療（CCRT）治療4周，分別在治療前 、治療 4周后進行臨床記憶量表（CMS）的評估，評價兩組患者治療前后記憶功能的改善。結果：治療前兩組患者的臨床記憶量表（CMS）各項指標方面比較，差異無統計學意義（P>0.05）;與同組治療前相比，兩組患者治療后CMS各項指標均顯著改善，差異均具有統計學意義（t指向記憶 2.226，2.640;t聯想學習4.410，3.936;t圖像記憶4.521，2.718;t圖像再認2.242，2.232;t人像特點回3.836，3.596;t記憶商數7.717，4.945; P<0.05）;經治療4周后，首發組患者CMS各項評分指標顯著優于復發組，差異均具有統計學意義（t指向記憶2.498，t聯想學習2.724，t圖像記憶2.399，t圖像再認2.614，t人像特點回憶2.968，t記憶商數2.459， P<0.05）。結論： CCRT能改善抑郁癥患者的記憶功能，而且首發患者效果更好。

【關鍵詞】首發與復發抑郁癥;計算機認知矯正治療;記憶功能

【中圖分類號】R749.4+1 ? ?【文獻標識碼】A ? ? ?【文章編號】1672-3783（2020）07-0033-02

【Abstract】Objective：To compare the improvement of memory function in patients with first and recurrent depression treated by computer cognitive correction. Methods：The 50 patients at the stage of acute depression were divided into the first episode group and the recurrence group according to the attack times in Guangxi Brain Hospital from May 2017 to December 2018.Patients in both groups were be treated by esitalopram oxalate and computer cognitive correction therapy （CCRT） for 4 weeks， the clinical memory scale （CMS） was used to evaluate the improvement of memory function before and after treatment. Results：there was no significant difference in the clinical memory scale （CMS） between the two groups （P > 0.05） before treatment. Compared with the same group before treatment， all indicators of CMS in the two groups were significantly improved after treatment， and the differences were statistically significant （tpoint to memory ?2.226 and2.640 ， tassociative learning 4.410 and 3.936，timage memory 4.521 and 2.718，timage recognition 2.242 and 2.232，tportrait feature recall 3.836 and3.596，tmemory quotient 7.717and 4.945，P < 0.05）; After 4 weeks of treatment， the CMS scores of the first-episode group were significantly better than those of the relapse group， with statistically significant differences （t Point to memory 2.498， t associative learning 2.724， t image memory 2.399， t image recognition 2.614， t portrait feature recall 2.968， t memory score 2.459， P < 0.05）. Conclusion：CCRT can improve the memory function of patients with depression， and the effect is better in the first episode patients.

【Key words】First episode and recurrent depression;Computer cognitive correction therapy; Memory function

抑郁癥被列為全球疾病負擔最重病癥之一[1]，是一種以情緒低落、興趣減退、思維遲緩、認知功能損害為主要特征的情感障礙性疾病[2]。當前認為多數抑郁癥患者存在顯著的記憶障礙[3]，其中，記憶功能受損顯著作用于抑郁癥的康復，甚至降低康復后的生活質量。臨床研究表明計算機認知矯正治療系統（Computerized cognitive remediation therapy ， CCRT）對精神分裂癥的認知功能受損具有明確療效[4-6]，國內部分研究也認為，CCRT能有效改善抑郁癥患者的認知功能，并影響其記憶功能。故本研究旨在探討CCRT對抑郁癥患者的記憶功能改善的效果，以及比較CCRT對首發與復發性抑郁癥患者記憶功能改變的差異。