海洛因依赖者在环境线索诱发时HPA轴功能的变化  

CHANGES OF THE ACTIVITY OF HYPOTHALAMO-PITUITARY-ADRENOCORTICAL AXIS DURING HEROIN DEPENDENCE AND CUE-INDUCED CRAVING

作　　者：杜江[1] 赵敏[1] 谢斌[1] 陆光华[1] 徐韩[1] 朱敏[1] 江海峰[1] 

机构地区：[1]上海市精神卫生中心,上海200030

出　　处：《中国药物依赖性杂志》2006年第6期451-454,共4页Chinese Journal of Drug Dependence

基　　金：上海市卫生局科研基金项目(编号:34031)

摘　　要：目的:了解海洛因依赖者下丘脑-垂体-肾上腺轴(HPA)系统的功能状态及环境线索诱发心理渴求时的促肾上腺皮质激素(ACTH)与血浆中皮质醇(cortisol,CORT)水平的变化特点。方法:比较19例脱毒后期海洛因依赖者与21正常对照者血清ACTH和CORT水平,分析19例海洛因依赖者环境线索诱发前后的心理渴求程度、血压、心率、瞳孔直径等生理指标、ACTH和CORT水平的变化特点。结果:戒断后期海洛因依赖者血清ACTH呈现高于正常对照组的趋势(t=1·663,P=0·104),CORT水平显著高于对照组(t=3·142,P=0·003);环境线索可诱发海洛因依赖者出现心理渴求,引其心律加快、血压上升、瞳孔变大,但血清ACTH和CORT水平改变不明显(P>0·05)。结论:戒断后期海洛因依赖者HPA系统功能升高,环境线索可诱发海洛因依赖者产生心理渴求和某些生理指标改变,提示降低海洛因依赖者对环境线索的敏感性及调整HPA功能可能有助于降低心理渴求及预防复吸。Objective： To understand the function of activity of hypothalamo - pituitary - adrenocortical （HPA） axis during heroin dependence and the changes of ACTH and cortisol during heroin related cue - induced craving. Methods： The blood levels of ACTH and cortisol were compared between heroin dependent patients shortly after detoxification （n = 19） and control group （n = 21）. Self-reported craving, blood pressure, heart rates, diameter of pupil, blood level of ACTH and cortisol were measured in heroin dependent patients before and after heroin related cue exposure. Results： The blood level of cortisol in heroin dependent patients shortly after detoxification was higher compared with that in controls （ t = 3. 142, P = 0. 003 ）, the blood level of ACTH in heroin dependence patients also showed a higher tendency compared with that in controls （t = 1. 663, P =0. 104）. Heroin related cue exposure induced self reported craving, increased the heart rates, blood pressure, and the diameter of pupil in heroin dependent patients, but did not produce significant changes in their blood levels of ACTH and cortisol （P 〉0. 05 ）. Conclusion ： The HPA axis is increased shortly after detoxification in heroin dependent patients. Heroin related cue exposure induces craving and produces physiological changes among heroin dependent patients. It is suggested that to decrease the sensitivity of drug use related cues may be of help to decrease craving and prevent relapse.

关 键 词：海洛因依赖 环境线索 促肾上腺皮质激素 皮质醇 

分 类 号：R595.5[医药卫生—内科学]