丁丙诺啡舌下片合并东莨菪碱、异丙嗪药物依赖者停药后脑白质的弥散张量成像纵向研究  

White matter abnormalities among the abstinent patients with dependence on sublingual bnprenorphine, scopolamine and promethazine： a longitudinal diffuse tensor imaging study

作　　者：周旭辉[1] 王绪轶[1] 张四方[1] 谌红献[1] 向小军[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

出　　处：《中华行为医学与脑科学杂志》2011年第9期803-805,共3页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家重点基础研究发展973计划项目（2009CB522000）;国家自然科学基金项目（30370522）;中南大学研究生教育创新工程立项资助项目（2340-77205）

摘　　要：目的观察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（BSP依赖者）停药后脑白质完整性的动态变化。方法采用弥散张量成像（DTI）方法对16例BSP依赖者停药后第3天、第1个月以及第2个月各向异性分数（FA）进行了广1身前后对比研究，并设立18例正常对照组。结果与正常对照组相比，停药3dBSP依赖者额叶（14，4H．-16；28，-26，46）、胼胝体（18，30，-14；-14，26，-12）、顶叶（-50，-26，26）、颞叶（-46，-40，6；34，-62，8）区域白质FA值显著性低于正常对照组（P〈0．001）。与停药3d相比，BSP依赖者停药1个月白质FA值没有变化，停药后2个月部分脑区白质FA值有所增高，包括左侧额上回（-20，50，18）、右侧额中回（30，-20，44）以及右侧顶下小叶（38，-30，34），差异有显著性（P〈0．001）。对比停药2个月BSP依赖者与正常对照组，先前受损严重的腑区额叶、胼胝体、顶叶、颞叶区域白质FA值仍低于正常对照组（P〈0．01）。结论BSP滥用导致白质完整性的损害随着戒断时间的延长，前额叶等受损脑区在停药2个月后可得到部分恢复，但仍不能达到正常水平。Objectives To explore the brain white matter integrity among the patients with buprenorphine tables,scopolamine and promethazine solution（BSP） dependence after abstinence. Methods BSP-dependent patients（ n = 16）and age/eduction-matched healthy control subjects （ n = 18 ） were assessed by diffusion tensor imaging（DTI） after 3 days, 1 month and 2 months of abstinence. White matter （WM） integrity was measured with DTI as fractional anisotropy （FA） , an index of intravoxel ofientational coherence of white matter fibers. Results Compared with health controls, FA values were significantly lower in frontal, parietal, temporal and corpus callosmn in the BSP addicts after 3-day withdrawal （P 〈 0. 001 ,uncorrected）. Increased FA values in left superior frontal cortex, right medial frontal gyrus and right inferior parietal gyrus were found in BSP users after 2 months of abstinence （P〈 0. 001,uncorrected）. However, no significant difference was found between these BSP addicts after 1-month abstince. Compared with health controls,BSP dependent subjects still exhibited significantly lower FA in the corpus callosum, frontal, parietal and temporal WM after 2-month withdrawal （P 〈 0. 001, uncorrected ）. Conclusion The abnormalities showed less recovery in BSP dependent individuals with abstinence in white matter that suggests that rehabilitation time should be further prolonged for BSP addicts and emphasis cognitive-behavioral therapy to assist BSP abusers rebuild social functions.

关 键 词：丁丙诺啡 东莨菪碱 异丙嗪 白质 弥散张量成像 

分 类 号：R749.64[医药卫生—神经病学与精神病学]