5年随访研究海洛因复吸的预测因子——气质、冲动性和COMT基因多态性的性别差异  

Gender differences of factors—temperament, impulsivity, and polymorphism of COMT gene for predicting the relapse of heroin by a 5-year follow up

作　　者：苏杭 李质彬 杜江[1] 江海峰[1] 陈志康 孙海明[1] 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：《上海交通大学学报（医学版）》2015年第10期1452-1457,共6页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81271468;81130020);上海市卫计委基金(2014ZYJB0002;2013SY011);上海精神疾病重点实验室基金(13DZ2260500)~~

摘　　要：目的在一项5年的随访研究中探讨海洛因复吸预测因子气质、冲动性以及COMT基因多态性的性别差异。方法使用Barratt冲动量表、气质性格问卷评估564例海洛因依赖患者的冲动性、气质和性格特质。使用DNA序列检测系统检测COMT基因rs4680多态性。结果在564例海洛因依赖者中,完成5年随访的共有500例。在完成5年随访的患者中,有265例(53%)患者被确诊为海洛因复吸,其中男性127例,女性138例。Logistic回归分析显示:在5年随访过程中,男性冲动量表总分、美沙酮治疗史以及用药年限是海洛因复吸的预测因子;而在女性中,用药起始年龄、酒依赖史、美沙酮治疗史以及自我定向性得分是海洛因复吸的预测因子。结论气质、冲动性以及COMT基因多态性与海洛因复吸有关,这些因素在预测海洛因复吸的过程中存在性别差异。Objective To investigate gender differences of factors （temperament, irnpulsivity, and polymorphism of COMT gene） for predicting the relapse of heroin by a 5-year follow up. Methods Impulsivity, temperament, and character of 564 heroin dependent patients were evaluated by Barratt impulsiveness scale （BIS） and temperament and character inventory. The polymorphism of COMT gene rs4680 was detected by a DNA sequence detection system. Results Among 564 heroin dependent patients, 500 patients were followed up for 5 years. 265 （530/0） of them relapsed into heroin and 127 patients were male and 138 patients were female. Logistic regression analysis showed that the total score of BIS, methadone maintenance treatment, and duration of heroin use were factors for predicting the relapse of heroin according to 5 years of follow up. For females, the starting age of heroin use, alcohol dependent, methadone maintenance treatment, and score of self orientation were factors for predicting the relapse of heroin. Conclusion The impulsivity, temperament, and polymorphism of COMT gene are relevant to the relapse of heroin. Gender differences exist for predicting the relapse of heroin by these factors.

关 键 词：性别差异 海洛因 复吸 气质 冲动性 COMT基因多态性 随访 

分 类 号：R749.64[医药卫生—神经病学与精神病学]