目的：探讨加速高频重复经颅磁刺激（accelerated high-frequency repetitive transcranial magnetic stimulation，aHF-rTMS）对青少年抑郁症患者的疗效及安全性。方法：选取我院精神科57例伴有自杀意念的青 少年抑郁发作患者，随机分为标准组（30例）和加速组（27例）。标准组给予标准重复经颅磁刺激（rTMS）治 疗14 d，加速组给予aHF-rTMS治疗7 d。分别在治疗前（T1）以及治疗后第1周（T2）、第2周（T3）、第4周 （T4）进行汉密尔顿抑郁量表-24项（Hamilton depression scale-24，HAMD-24）、自杀意念量表（scale for suicide ideation，SSI）、临床总体印象量表-疾病严重程度分量表（clinical global impression-severity of illness scale，CGI-SI）评定。结果：2组T1期HAMD、SSI、CGI-SI量表总分差异无统计学意义（P＞0.05）。与T1期 比较，2组在T4期的HAMD、SSI及CGI-SI分数有不同程度下降（P＜0.05）；与标准组同期比较，加速组SSI 总分在 T2 时下降更为显著（t＝－5.542，P＜0.05）；2 组在 T4 期 HAMD、SSI 及 CGI-SI 差异无统计学意义 （P＞0.05）。T4期时，加速组显效率为77.8%，高于标准组的53.3%，但差异无统计学意义（P＞0.05）。2组 治疗期间不良反应发生率差异无统计学意义（P＞0.05），且未发生严重不良反应。结论：aHF-rTMS治疗可 以改善青少年抑郁症患者的抑郁情绪及自杀意念，其在治疗4周内的疗效及安全性等同于标准rTMS治 疗，而且aHF-rTMS治疗在快速降低患者的自杀意念上更有优势。

To investigate the efficacy and safety of accelerated high-frequency repetitive transcranial magnetic stimulation (aHF-rTMS) in adolescents with depression. Methods: Fifty-seven adolescent depressive episode patients with suicidal ideation in the psychiatric department of our hospital were selected and assigned to the accelerated and standard groups. The accelerated group received aHF-rTMS for 7 days, and the standard group received standard rTMS for 14 days. Twenty-four items of the Hamilton Depression Scale (HAMD-24), Scale for Suicidal Ideation (SSI), and Clinical Global Impression-Severity of Illness (CGI-SI) were used for evaluation. Results: There were no significant differences in the total scores of the HAMD, SSI, and CGI-SI scales at T1 between the two groups (P>0.05). Total scores of HAMD, SSI, and CGI-SI at T4 decreased to different degrees in both groups (P<0.05) compared to T1. Total score of SSI in T2 in the accelerated group decreased more than that in standard group (t=－5.542, P<0.05). There were no significant differences in the total scores of the HAMD, SSI, and CGI-SI scales at T4 between the two groups (P>0.05). The total significant efficiency in the accelerated group at T4 was 77.8% , which was higher than that in standard group, but there was no significant differences (P>0.05). There were no significant differences in the incidence of adverse reactions between the two groups during treatment (P>0.05). Conclusion: aHF-rTMS treatment can improve depressive mood and suicidal ideation in adolescent patients with depression, and its efficacy and safety within 4 weeks of treatment are the same as those of standard rTMS treatment. Furthermore, aHF-rTMS treatment has more advantages in rapidly reducing suicidal ideation in patients.