阿片类物质依赖者戒断期间机体免疫功能的变化以及济泰片干预的影响  

Changes and the impact on immune function of opioid-dependent subjects by Jitai tabelets during the withdrawal stage

作　　者：李潇潇[1] 范华莹[2] 孙莉[3] 梁军成[3] 邓艳萍[3] 

机构地区：[1]北京大学第三医院药剂科,100191 [2]北京大学人民医院科研处,100044 [3]北京大学中国药物依赖性研究所,100191

出　　处：《中华流行病学杂志》2017年第4期531-536,共6页Chinese Journal of Epidemiology

基　　金：国家科技支撑计划（2008BA149801）

摘　　要：目的 探讨阿片类物质依赖者戒断期间免疫功能的变化和济泰片的影响。方法 采用随机、双盲、安慰剂平行对照试验，受试者分别给予济泰片、济泰片联合丁丙诺啡、安慰剂治疗，戒断前、戒断后第14天检测血清中免疫球蛋白（IgM、IgA、IgG）、T细胞亚群（CD3＋、CD4＋、CD8＋、CD4＋/CD8＋比例）以及细胞因子（IL-2、IFN-γ、IL-4、IFN-γ/IL-4比例）水平。结果 戒断前，阿片类物质依赖者IgM水平为（1.67±0.87）g/L，IL-2、IFN-γ、IL-4占CD3＋CD8-细胞比例分别为（14.44±13.50）%、（20.23±15.10）%、（1.97±1.59）%，高于健康对照，差异有统计学意义（P〈 0.05）；CD3＋T细胞水平为（47.01±13.62）%，低于健康对照，差异有统计学意义（P〈 0.05）；其余免疫学指标与健康对照相比差异无统计学意义（P〉 0.05）。安慰剂戒断第14天，IL-4水平降至正常水平，IFN-γ/IL-4比例升高3.43倍（P〈 0.05），IgA、IgG、CD4＋ T细胞水平及CD4＋/CD8＋比例在正常范围内波动；其余免疫学指标与戒断前相比差异无统计学意义（P〉 0.05）。与安慰剂相比，济泰片可减小戒断期间IgG、IgM水平的波动，并使戒断第14天时IgM水平恢复正常；济泰片联合丁丙诺啡可使IL-4水平异常升高0.54倍，IFN-γ/IL-4比例降低至正常（P〉 0.05）。药物干预不影响戒断期间其余免疫指标的变化。结论 戒断时免疫功能有一定程度的损害，济泰片治疗有助于损伤的修复。Objective To detect the changes in the immune function of opioid-dependent subjects during the withdrawal stage through the administration of Jitai tablet. Methods Subjects were treated as Jitai tablet alone, Jitai tablet plus buprenorphine and placebo, in a randomized,double-blind, placebo-controlled trial. Before and after the 14th day of withdrawal, levels of immunoglobulin （IgM, IgA, IgG）, T cell subsets （CD3＋, CD4＋, CD8＋, CD4＋/CD8＋） and cytokines （IL-2, IFN-γ, IL-4, IFN-γ/IL-4） were detected. Results Compared with healthy people, immunity function before withdrawal among the opioid abusers showed higher levels of IgM, IL-2, IFN-γ, IL-4 and lower level of CD3＋ T, as （1.67±0.87） g/L, （14.44±13.50）%, （20.23±15.10）%, （1.97±1.59）%, （47.01±13.62）%, respectively, with difference statistically significant （P〈 0.05）. There was no big difference of other immunity indicators between the two groups （P〉 0.05）. At the 14th day of withdrawal in placebo group, levels of IL-4 returned to normal while IFN-γ/IL-4 ratio increased by 3.43 times （P〈 0.05）. Levels of IgA, IgG, CD4＋ and CD4＋/CD8＋ ratio fluctuated within normal range. There were no significant changes in other immunity indicators （P〉 0.05）. Compared with placebo group, fluctuation of IgG and IgM decreased in Jitai group during withdrawal period, together with a normal level of IgM at the 14th day. Level of IL-4 abnormally rose up by 0.54 times in Jitai tablet plus buprenorphine group, while IFN-γ/IL-4 ratio been switched back at the 14th day of withdrawal. Other immune indicators were not affected by medical interventions. Conclusion We noticed that certain impairment of the immune function might be restored by Jitai tablet during the withdrawal period.

关 键 词：阿片类依赖 免疫球蛋白 T细胞亚群 济泰片 

分 类 号：R749.64[医药卫生—神经病学与精神病学]