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背景:长效纳曲酮缓释剂临床应用近1年后,若干报道结果证明患者情绪状态改善,心瘾减退,希望进一步探寻长效纳曲酮缓释剂戒毒对记忆力恢复的神经心理学证据。目的:观察长效纳曲酮缓释剂治疗对阿片类药物依赖者词语记忆能力的影响。设计、时间及地点:对比观察实验,于2006-10/12在湖北省武汉市公安戒毒所、湖南省常德市、河南省郑州市和广东省阳江市各地自愿戒毒所完成,健康对照组测试于2006-10在北京大学深圳医院完成。对象:男性阿片依赖综合征患者88例,包括长效纳曲酮缓释剂治疗组35例,强制戒毒组26例,未治疗组27例,另选择22名健康志愿者作为对照组。方法:长效纳曲酮缓释剂治疗组在测试前6~12个月腹壁两侧皮下植入长效纳曲酮缓释剂3.1g,强制戒毒组接受全封闭强制戒毒6个月,至测试之日止现场进行尿液海洛因、美沙酮和丁丙诺啡定性检测全部为阴性。采用便携式事件相关电位工作系统于各戒毒所现场采集记录3组不同戒毒方式治疗的阿片类药物依赖患者以及健康对照组完成新旧词语再认记忆任务时脑电事件相关电位及事件相关电位的波形。主要观察指标:对词语记忆的正确率和反应时,语言相关电位-N400的潜伏期和波幅。结果:①3组患者对词语记忆的正确率和反应时与健康对照组比较差异有非常显著性意义(P<0.001);长效纳曲酮缓释剂治疗组词语记忆正确率提高,反应时缩短,与强制戒毒组和未治疗组比较差异有显著性(P<0.05)。②3组患者完成词语记忆的N400潜伏期比健康对照组显著延长(P<0.01);长效纳曲酮缓释剂治疗组其N400的波幅提高,与健康对照组比较差异无显著性(P>0.05),与强制戒毒组和未治疗组相比差异有显著性意义(P<0.01)。结论:长效纳曲酮缓释剂治疗能有效改善阿片类药物依赖者神经系统的功能,提高患者的词语记忆能力。
Background: Long-acting naltrexone sustained-release agents clinical application nearly a year later, a number of reported results show that patients with emotional status improved, heart addiction, hoping to further explore long-term naltrexone sustained release drug detoxification on memory recovery neuropsychological evidence . Objective: To observe the effects of long-acting naltrexone sustained-release tablets on the ability of word memory in opiate dependent patients. DESIGN, TIME AND SETTING: The comparative observation experiment was conducted at the voluntary rehabilitation center in Wuhan Public Security Center, Wuhan City, Hubei Province, Changde City, Hunan Province, Zhengzhou City, Henan Province and Yangjiang City, Guangdong Province from October to December 2006. The healthy control group was tested at 2006-10 Completed at Peking University Shenzhen Hospital. PARTICIPANTS: A total of 88 male patients with opioid dependence syndromes, including 35 long-acting naltrexone-treated patients, 26 intensive-treatment patients and 27 untreated patients. Another 22 healthy volunteers were selected as control group. Methods: The long-acting naltrexone sustained-release treatment group was subcutaneously implanted with 3.1g of long-acting naltrexone sustained-release agent on both sides of the abdominal wall 6 to 12 months before the test. The compulsory detoxification group was subjected to full- Urine heroin, methadone and buprenorphine qualitative tests were all negative on the test day. Portable event-related potential working system was used to collect and record waveforms of EEG-related potential and event-related potentials of three groups of opioid-dependent patients and healthy control group who completed the re-recognition of old and new words of memory task at each detoxification site. MAIN OUTCOME MEASURES: The correct rate and response to the word memory, latency and amplitude of the language-related potential-N400. Results: ①The correct rate of word memory and reaction time of the three groups of patients were significantly different from the healthy control group (P <0.001); the long-acting naltrexone sustained-release agent treatment group improved the correctness of the word memory and the reaction time shortened , There was significant difference between mandatory detoxification group and untreated group (P <0.05). ② The latency of N400 in term memory of the three groups was significantly longer than that in the healthy control group (P <0.01). The amplitude of N400 in the long-acting naltrexone sustained-release agent treatment group was significantly higher than that in the healthy control group (P> 0.05 ), Compared with compulsory treatment group and untreated group, there was significant difference (P <0.01). Conclusion: The long-acting naltrexone sustained-release agent can effectively improve the function of the neurological system of opioid-dependent patients and improve the ability of patients to remember words.