长期吸食甲基苯丙胺对决策功能的影响  

Decision-making Impairment caused by chronic methamphetamine use

作　　者：肖乐[1,2,3] 袁晓菲[1] 阎锴娟[1] 崔少娟[1] 李亚琼[1] 张国富[1] 陈群[1] 罗小年[1] 

机构地区：[1]首都医科大学附属北京安定医院,100088 [2]北京市精神疾病诊断与治疗重点实验室 [3]国家精神心理疾病临床医学研究中心(首都医科大学附属北京安定医院)

出　　处：《临床精神医学杂志》2016年第2期112-114,共3页Journal of Clinical Psychiatry

基　　金：国家科技支撑项目(2012BAI01B07);北京市科委脑重大疾病数据的采集规范及挖掘分析研究(Z151100003915117)

摘　　要：目的:探讨长期吸食甲基苯丙胺对决策功能的影响。方法:选取46例男性甲基苯丙胺依赖者和27名健康男性对照,使用爱荷华博弈任务(IGT)评估决策行为。采用5(决策组块)×3(被试类别)混合设计,根据选择的先后顺序将全部100次选择划分为5个决策组块;被试类别包括长期吸毒组(吸毒时间≥5年)、短期吸毒组(吸毒时间<5年)和对照组3类。结果:决策组块主效应不显著,F(4,280)=1.780,P=0.133;被试类别主效应显著,F(2,70)=4.190,P=0.019,;两者的交互作用显著,F(8,280)=2.060,P=0.040。Post Hoc检验,长期吸毒组的总体IGT分数与对照组、短期吸毒组比较差异有统计学意义(P均<0.05),而短期吸毒组与对照组之间差异无统计学意义(P>0.05)。固定被试类别的简单效应分析结果显示,决策进程对长期吸毒组的净分数无显著影响,F(4,92)=1.986,P=0.103,而决策进程对正常对照组、短期吸毒组的净分数存在显著影响,分别为F(4,104)=3.017,P=0.021;F(4,84)=2.961,P=0.047。结论:长期吸食甲基苯丙胺导致患者决策能力受损,短期吸毒者的决策能力相对完好。Objective： This study examined the long-term effect on the reward-related decision-making among methamphetamine dependent patients（ MD）. Method： The Iowa gambling task（ IGT） was performed by 46 patients with methamphetamine dependence and 27 normal controls. Using 5（ decision block） × 3（ group） mixed design,100 choices were divided into 5 decision block according to the sequence of choice,and the subjects included long-term methamphetamine group（ LMG,drug duration ≥5 years）,short-term methamphetamine group（ SMG,drug duration 〈5 years） and healthy control group（ HCG）. Results： There were no significant main effect of decision block on IGT scores [F（ 4,280） = 1. 780,P = 0. 133 ],but main effect on IGT scores of group was significant [F（ 2,70） = 4. 190,P = 0. 019]. Significant interaction effect between group and block was also observed [F（ 8,280） = 2. 060,P = 0. 040]. Post Hoc pairwise comparison showed IGT score of LMG was significantly different from SMG and HCG（ P 〈0. 05）,while no differences were observed between SMG and HCG（ P 〉0. 05）. After fixing the effects of group to explore the main effect of decision block,no significant differences were observed in each blocks of LMG[（ F（ 4,92） = 1. 986,P = 0. 103]. A tendency to make better choices during the process of the task was observed in HCG and SMG,with F（ 4,104） =3. 017,P = 0. 021; F（ 4,84） = 2. 961,P = 0. 047 respectively. Conclusion： Long-term methamphetamine use leads to impaired decision-making ability,while the impairment in short-term abusers is not obvious.

关 键 词：甲基苯丙胺依赖 爱荷华博弈任务 决策 

分 类 号：R749.6[医药卫生—神经病学与精神病学]