丁丙诺啡舌下片合并东莨菪碱、异丙嗪药物依赖者脑白质完整性的研究  

OBSERVATION ON WHITE MATTER INTEGRITY AMONG THE ABSTINENT PATIENTS WITH DEPENDENCE ON SUBLINGUAL BUPRENORPHINE,SCOPOLAMINE AND PREMETHAZINE

作　　者：周旭辉[1,2] 王绪轶[1] 刘军[1] 郝伟[1] 

机构地区：[1]中南大学湘雅二医院精神卫生研究所,长沙410011 [2]湖南省脑科医院,长沙410007

出　　处：《中国药物依赖性杂志》2011年第2期105-110,共6页Chinese Journal of Drug Dependence

基　　金：国家973资助项目(2003C515400);国家自然科学基金(30370522);中南大学研究生教育创新工程立项(2340-77205)资助

摘　　要：目的:观察在中国南方新近出现的盐酸丁丙诺啡舌下片合并东莨菪碱、异丙嗪药物依赖者(简称BSP依赖者)脑白质完整性的变化,并比较其与海洛因依赖者脑结构损害的异同。方法:采用弥散张量成像方法对16例BSP依赖者、20例海洛因依赖者停药3 d各向异性分数(fractional anisotropy,FA)进行组间对照研究,并设立18例正常对照者。结果:与正常对照组相比,BSP依赖者额叶、胼胝体、顶叶以及颞叶脑区FA值降低;与海洛因依赖组相比,BSP滥用组在左侧后扣带回处白质FA值低于海洛因依赖组,其他区域未见差异;BSP依赖者和海洛因依赖者均存在双侧胼胝体前端FA值降低。结论:BSP依赖者额叶、胼胝体、顶叶以及颞叶脑区白质完整性下降,这进一步提示神经核团(灰质)之间神经联系(白质)的损害可能是脑功能连接异常的结构基础。前额叶和胼胝体前端FA值降低可能是药物依赖者一个重要影像学特征。Objective： Recently,an intravenous abuse of buprenorphine tables,scopolamine and promethazine solution（BSP）has been emerging among heroin-dependent individuals in some areasof Southern China.The aim of this study was to explore the brain structural pathological changesin the patients with BSP dependence,by diffusion tensor imaging（DTI）.Methods：BSP-dependent patients（n=16）,heroin-dependent individuals（n=20）and age/education-matched healthy control subjects（n=18）were assessed by fractional anisotropy（FA）during resting state.Patients with BSP and heroin dependencewere examined by DTIscanning after 3 days of abstinence,while control subjects weretested only once.Results：BSP dependent subjects exhibited significantly lower FA in the corpus callosum,frontal,parietal and temporal white matter（WM）.The WM lesions in BSP addicts were similar to those of heroin-dependentindividuals.Results of the DTI showed significantly reduced FA in the anterior corpus callosum in both BSP users and heroin dependent subjectscompared to normal controls.Conclusion：BSP dependent patients showed reduction in WM integrality in frontal,parietal and temporal regions and corpus callosum,which further suggeststhat the WM lesions between neural nucleuses may be the neuropathological substrate of abnormal functional connectivity.Reduced FA in the anterior corpus callosum and prefrontal lobe may be a valuable imaging feature in drugaddicts.

关 键 词：丁丙诺啡 东莨菪碱 异丙嗪 白质 各向异性分数 弥散张量成像 

分 类 号：R996[医药卫生—毒理学]