海洛因依赖者环境线索诱发心理生理反应及相关因素分析  

An analysis on cue-induced craving and the related factors among heroin dependence

作　　者：杜江[1] 范成路[1] 孙海明[1] 陈晗辉 赵敏[1] 

机构地区：[1]上海交通大学医学院附属精神卫生中心,上海200030

出　　处：《中华行为医学与脑科学杂志》2010年第1期27-29,共3页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：上海市卫生局科研基金（054129）

摘　　要：目的了解环境线索诱发海洛因依赖者心理渴求及生理反应情况，探讨影响渴求反应的相关因素。方法369名成断时间大于1年的海洛因依赖患者观看吸毒相关视频的同时给予海洛因模拟物及吸毒用具刺激，根据被试者的自我报告，采用视觉模拟评分法评价线索诱发前与诱发后的心理渴求程度；使用生物反馈仪记录诱发前、中、后的心理与生理指标；采用冲动行为调查问卷（BIS—Ⅱ）和自制吸毒行为调查问卷评估患者冲动特质和毒品使用情况。采_}}j重复测量方差分析和Logistic回归分析比较线索诱发前、中、后渴求变化及生理指标的差异并分析影响心理渴求的因素。结果海洛因依赖者在环境线索诱发后心理渴求（t=11．24；P〈0．01）及生理指标[心率（76．6±11．3）次／分，F=19．23；收缩压（134．4±15．8）mmHg（1mmHg=0．133kPa），F=94．5；舒张压（86．9±10．6）mmHg，F=95．0；皮导（7．48±4．25）μs，F=53．99；瞳孔t=11．73）改变显著（P〈0．01）：Logistic回归分析显示，冲动特质得分高的被试者更容易诱发出心理渴求（P=0．001，95% CI：1．015～1．065）。结论长期戒断的海洛因依赖患者在环境线索诱发下仍存在明显的心理渴求；冲动特质对环境线索诱发的渴求反应影响显著。Objective To understand the cue-induced craving, physiological reactions to heroin-related cues, and to explore the factors that impact the cue-induced craving. Methods 369 abstinent heroin addicts were exposed to videotapes of heroin using and sinmlaerum after the self relaxation. The craving, abstinent symptoms were measured before and after cue exposures. The physiological reactions were measured by multi-biofeedback instrument before, during, and after cue exposure. BIS-Ⅱ questionnaire was used to collect information about their impulsive characteristic. Results After cue exposure, the self-reports scores of craving （t = 11. 24, P 〈 0.01 ）, physiological index including heart rate （ （ 76.6 ± 11.3 ） beats/rain, F = 19.23 ）, skin conduct （ （ 7.48 ± 4.25 ）μs, F = 53.99） , pupil size （t = 11. 73 ）had significant change in heroin addicts（P 〈 0.01 ）. Logistic regression results showed that the scores of BIS-11 were related to cue-reduced craving（P = 0. 001,95% CI： 1. 015 1. 065）. Conclusions Exposure to drug-related cues can induces craving and physiological reactions in long term abstinence heroin addicts. High impulsive characteristic is a risk factor to induce drug-related craving. The intervention strategies should consider the impulsive characteristic and make a comprehensive intervention program to prevent relapse.

关 键 词：海洛因依赖 线索诱发 心理生理指标 

分 类 号：R749.64[医药卫生—神经病学与精神病学]