摘要/Abstract
摘要： 目的· 探讨电抽搐治疗老年抑郁症患者的临床疗效及安全性。方法· 检索PubMed、EMBase、Web of Knowledge、中国期刊
网、万方、维普及中国生物医学文献等数据库，以随机临床试验报告的声明为参照标准进行入组和评价文献，采用RevMan 和STATA
软件进行meta 分析。结果· 共有10 篇文献纳入系统评价，分别对使用汉密尔顿抑郁量表（HAMD，n=5）及蒙哥马利抑郁量表
（MADRS，n=3）的研究进行抑郁症状疗效的汇总分析。治疗前、后的样本量分别为306 例和290 例，结果显示无论使用何种抑郁症
状评估工具，老年抑郁症经过电抽搐治疗后，抑郁症状均显示有所改善（HAMD：Z=6.39，SMD=3.64，P=0.000；MADRS：Z=15.47，
SMD=2.12，P=0.000）。简易智力状况检查量表（MMSE）评分治疗前后差异无统计学意义（Z=1.47，P=0.140）。发生率大于5% 的不
良反应有头痛、意识模糊、嗜睡、恶心呕吐等。结论· 电抽搐治疗老年抑郁症患者后，其抑郁症状改善显著，整体认知功能损害不明
显，但易发生头痛、意识障碍等不良反应。
关键词: 电抽搐治疗, 老年, 抑郁, 随机对照研究, meta 分析
Abstract:
Objective · To explore the clinical effectiveness and safety of electroconvulsive therapy (ECT) in elderly patients with depression.
Methods · Searches were made in PubMed, EMBase, Web of Knowledge, CNKI, Wanfang, VIP, CBMDisc databases and etc. CONSORT (Consolidated
Standards of Reporting Trials) statement were used to assess the methodological quality of the studies. RevMan and STATA were used to do meta analysis.Results · Ten studies were included in this systematic review. The studies which used Hamilton depression rating scale (HAMD, n=5) and MontgomeryÅsberg depression rating scale (MADRS, n=3) to access depressed symptom were analyzed. Sample size was 306 and 290 before and after treatment, respectively. The depressive symptoms were significantly improved after ECT treatment estimated by either HAMD (Z=6.39, SMD=3.64, P=0.000) or MADRS (Z=15.47, SMD=2.12, P=0.000). There was no difference of Mini-mental State Examination (MMSE) scores before and after the treatment
(Z=1.47, P=0.140). The incidence of adverse events of headache, confusion, drowsiness, nausea and vomiting was more than 5%. Conclusion · Depressed
symptoms are significantly improved in geriatric depression after ECT. The overall cognitive impairment is not obvious, but headache and disturbance of
consciousness are common.
Key words: electroconvulsive therapy, elderly, depression, randomized controlled trial, meta analysis
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