阿片类药物依赖者康复阶段免疫功能变化分析  

Analysis of immune function in opioid addicts during rehabilitation

作　　者：范华莹[1] 李潇潇[2] 施大庆 梁军成[4] 孙莉[4] 邓艳萍[4] FAN Hua-ying;LI Xiao-xiao;SHI Da-qing;LIANG Jun-cheng;SUN Li;DENG Yan-ping(Department of Science and Research, Peking University People’s Hospital, Beijing 100044, China;Pharmacy Department Peking University Third Hospital, Beijing 100191, China;Compulsory Isolated Detoxification Center, Shanghai 200434, China;National Institute on Drug Dependence, Peking University, Beijing 100191, China)

机构地区：[1]北京大学人民医院科研处,北京100044 [2]北京大学第三医院药剂科,北京100191 [3]上海市强制隔离戒毒所,上海200434 [4]北京大学中国药物依赖性研究所,北京100191

出　　处：《中国生化药物杂志》2017年第11期27-31,共5页Chinese Journal of Biochemical Pharmaceutics

基　　金：国家科技支撑计划(2008BAI49B01)

摘　　要：目的探讨阿片类药物依赖者在24周康复期间的免疫功能变化及其影响因素。方法本研究于2010年10月～2011年7月在上海市强制隔离戒毒所开展。阿片类药物依赖者经脱毒治疗后，于戒断第15天纳入研究，康复期间不使用戒毒药物，观察24周，检测免疫功能指标，分析其影响因素。结果康复入组时，与正常对照比较，阿片类药物依赖者免疫学指标发生明显改变。其中CD3+T细胞水平显著低于正常，IL-2、IFN-γ、TNF-α、IL-4、IL-6及IL-10含量显著高于正常，Th1/Th2平衡发生Th1向Th2漂移。随康复期延长，IgG显著升高，IgM显著降低，但变化均在正常范围内；CD3+T细胞含量明显增高，于第24周末恢复正常；血清细胞因子水平发生明显逆转，降至低于正常；Th1/Th2于第4周重新达到平衡；COR含量显著降低，于第4周末降至低于正常。免疫功能指标的变化与吸毒方式、复吸次数以及毒品使用时间存在一定的相关性。24周康复期间，IFN-γ及TNF-α处于较高水平的概率，焦虑症状严重者分别是轻者的1.26倍与1.11倍；IL-2及IL-10处于较高水平的概率，稽延性戒断症状重症者分别是轻症者的1.12倍与1.19倍。结论阿片类药物依赖者康复初期免疫功能仍表现异常，随康复时间延长而逐步好转，但细胞因子和COR下降乃至低于正常水平。提示免疫和内分泌功能水平的恢复可能需要较长时间。Objective To investigate the immune function and risk factors in opioid addicts during rehabilitation.Methods The study was conducted in compulsory isolated detoxification center of Shanghai in2010.10-2011.7.The opioid addicts who had been abstained from opioid for15d were enrolled as subjects.There was no pharmacotherapeutic treatment of drug addiction during the24week of study.The immune function indices and risk factors were analyzed.Results At the beginning of rehabilitation,lower CD3+T cell levels,as well as higher serum IL-2,IFN-γ,TNF-α,IL-4,IL-6and IL-10production were observed compared with the healthy subjects.Opioid withdrawal skewed T cells towards Th2polarization.During rehabilitation,IgG value was likely to elevate while IgM value reduced without beyond the normal range.The number of CD3+T cell in opioid addict had a trend of increase,and showed no significant difference compared to the healthy ones at the24th week.All the serum cytokines and cortisol expressed as decrease to suppression during24week.Besides,Th1/Th2recovered at the4th week,but the level of COR significantly decreased to below normal..The changes were related to method,duration of drug use,and times of relapse.HAMA was the risk factor for abnormal IFN-γand TNF-α(OR were1.26and1.11,respectively),while protracted withdrawal symptoms scores was the risk factor for abnormal IL-2and IL-10(OR were1.12and1.19,respectively).Conclusion The immune fuction in opioid addicts remained abnormal during initial rehabilitation.They were improved within24w of rehabilitation.However,the serum cytokines and cortisol decrease to suppression since the4th to12th week,which suggests that the recovery of immune function take a long time.

关 键 词：阿片 药物依赖 康复期 免疫功能 影响因素 

分 类 号：R595.4[医药卫生—内科学]