线索诱发海洛因渴求的临床特征、分子遗传学及功能磁共振研究
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摘要
目的 了解线索诱发海洛因依赖者心理渴求的临床特征及相关影响因素。
方法 380名戒断期海洛因依赖者(208名强制和172名自愿戒毒者)暴露于海洛因相关环境线索，Likert分级法评定暴露前后海洛因渴求程度，完成自编主观戒断反应问卷，测量暴露前后血压、心率、瞳孔直径大小，填写自编毒品使用情况和社会人口学资料。比较暴露前后海洛因渴求程度及心率、血压等生理指标的变化；寻找与线索诱发海洛因渴求程度相关的指标。
结果 1．全体被试者暴露后的渴求、心率、收缩压和瞳孔以及自愿戒毒被试者的舒张压均较暴露前明显增加(p＜0.01)。2．暴露后渴求及主观戒断反应女性高于男性(p＜0.05)。3．主观戒断反应、诱发后心率和毒品严重程度自评问卷与线索诱发的海洛因渴求呈正相关，成瘾时间与之呈负相关。
结论 1．环境线索能够诱导戒断期海洛因依赖者产生心理渴求和某些生理指标的变化，渴求程度存在个体差异及性别差异。2．主观戒断反应、诱发后心率、毒品自评严重程度和成瘾时间与海洛因渴求程度有关。
Abstract (Part I )
The Clinical Feature and Relative Factors of Cue-Elicited
Heroin Craving
Objective To explore the clinical feature and related factors of cue-elicited heroin craving.
Method 380 heroin addicts(208 subjects in compulsory rehabilitation center and 172 subjects in voluntary treatment center from Shanghai) were exposed to heroin-related cue. Cue-elicited heroin craving was evaluated by Likert Scale. Some physiological indexes have been measured before and after exposure. All the subjects filled the questionnaire of subjective withdrawal reaction, drug use and demographic data. We compared the difference of craving and physiological indexes before and after exposure. The level of craving has also been analyzed between the two centers and different gender. The related factors to cue-elicited heroin craving have been screened by step-wise correlation.
Results 1. Compared with before exposure, craving, heart rate, systolic pressure and pupil of all subjects and the diastolic pressure of subjects in voluntary center increased significantly (P<0.01). 2. Craving after exposure in female subjects was higher than that in male counterpart (P<0.05). 3. By step-wise regression, we found these factors including subjective withdrawal reaction, heart rate after exposure, and questionnaire of drug dependence self-evaluation were positively correlated with cue-elicited heroin craving. However, the beginning time of addiction was negatively correlated with heroin craving. Conclusion Craving and the change of some physiological indexes can been
elicited by heroin-related cue. The level of cue-elicited heroin craving is different among individuals and different gender. Some factors are correlated with cue-elicited heroin craving.
方法 380名戒断期海洛因依赖者(208名强制和172名自愿戒毒者)暴露于海洛因相关环境线索，Likert分级法评定暴露前后海洛因渴求程度，完成自编主观戒断反应问卷，测量暴露前后血压、心率、瞳孔直径大小，填写自编毒品使用情况和社会人口学资料。比较暴露前后海洛因渴求程度及心率、血压等生理指标的变化；寻找与线索诱发海洛因渴求程度相关的指标。
结果 1．全体被试者暴露后的渴求、心率、收缩压和瞳孔以及自愿戒毒被试者的舒张压均较暴露前明显增加(p＜0.01)。2．暴露后渴求及主观戒断反应女性高于男性(p＜0.05)。3．主观戒断反应、诱发后心率和毒品严重程度自评问卷与线索诱发的海洛因渴求呈正相关，成瘾时间与之呈负相关。
结论 1．环境线索能够诱导戒断期海洛因依赖者产生心理渴求和某些生理指标的变化，渴求程度存在个体差异及性别差异。2．主观戒断反应、诱发后心率、毒品自评严重程度和成瘾时间与海洛因渴求程度有关。
Abstract (Part I )
The Clinical Feature and Relative Factors of Cue-Elicited
Heroin Craving
Objective To explore the clinical feature and related factors of cue-elicited heroin craving.
Method 380 heroin addicts(208 subjects in compulsory rehabilitation center and 172 subjects in voluntary treatment center from Shanghai) were exposed to heroin-related cue. Cue-elicited heroin craving was evaluated by Likert Scale. Some physiological indexes have been measured before and after exposure. All the subjects filled the questionnaire of subjective withdrawal reaction, drug use and demographic data. We compared the difference of craving and physiological indexes before and after exposure. The level of craving has also been analyzed between the two centers and different gender. The related factors to cue-elicited heroin craving have been screened by step-wise correlation.
Results 1. Compared with before exposure, craving, heart rate, systolic pressure and pupil of all subjects and the diastolic pressure of subjects in voluntary center increased significantly (P<0.01). 2. Craving after exposure in female subjects was higher than that in male counterpart (P<0.05). 3. By step-wise regression, we found these factors including subjective withdrawal reaction, heart rate after exposure, and questionnaire of drug dependence self-evaluation were positively correlated with cue-elicited heroin craving. However, the beginning time of addiction was negatively correlated with heroin craving. Conclusion Craving and the change of some physiological indexes can been
elicited by heroin-related cue. The level of cue-elicited heroin craving is different among individuals and different gender. Some factors are correlated with cue-elicited heroin craving.
引文
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