神经认知功能与海洛因成瘾者美沙酮维持治疗效果的相关性  

Relationship between the effect of neurocognitive function on methadone maintenance treatment in the heroin addicts and neurocognitive function

作　　者：黄伟容 陈莉林[1] 余擎 HUANG Weirong;CHEN Lilin;YU Qing(Department of Psychiatry,the First Affiliated Hospital of Xiamen University,Xiamen 361003,China)

机构地区：[1]中国·厦门大学附属第一医院精神科,福建厦门361003

出　　处：《中国健康心理学杂志》2020年第8期1139-1144,共6页China Journal of Health Psychology

摘　　要：目的:考察神经认知功能与海洛因成瘾者接受美沙酮维持治疗效果的相关性,探讨神经认知功能在药物成瘾治疗中的作用。方法:106名海洛因药物成瘾者接受为期6个月的美沙酮维持治疗,并根据依从性将成瘾者划分为治疗完成组和脱失组;在参加维持治疗前,对所有成瘾者进行神经认知功能测验,评估成瘾者的反应抑制、风险决策、言语短时记忆以及认知灵活性等认知功能;在治疗6个月后对成瘾者进行随访,收集临床数据和社会功能数据。结果:①治疗完成组的神经认知功能得分包括反应抑制、风险决策和认知灵活性均好于脱失组(t=13.69,P<0.001;t=4.58,P<0.01;t=5.75,P<0.001);完成组的治疗效果和社会功能也好于脱失组(社会支持t=24.36,P<0.001;家庭关系t=30.18,P<0.001;生活满意度t=6.97,P<0.001);②成瘾者的认知功能如反应抑制和认知灵活性与社会功能如社会支持存在显著的相关性(r=-0.31,-0.29,P<0.01);③Logistic回归分析的结果显示成瘾者的反应抑制、风险决策和认知灵活性等认知功能对美沙酮维持治疗效果有显著影响(B=-0.98,P=0.001;B=0.72,P=0.017;B=-0.63,P=0.002)。结论:神经认知功能是影响海洛因成瘾治疗效果的重要因素,将来可以考虑把认知功能训练作为药物成瘾戒断治疗的辅助策略。Objective:To investigate the correlation between neurocognitive function and the effect of methadone maintenance treatment on heroin addicts,and to explore the role of neurocognitive function in the drug addiction treatment.Methods:A total of 106 heroin addicts who participated in methadone maintenance treatment were included in the study.Neurocognitive function tests were performed to assess cognitive function including response inhibition,risk decision-making,verbal short-term memory,and cognitive flexibility before the treatment.Subjects received 6 months of methadone maintenance treatment;Then they were divided into treatment complete group and quitter group based on the compliance;The clinical data and social functional data of all subjects were collected after 6 months.Results:① The neurocognitive function scores of the complete group including response inhibition,risk decision-making,and cognitive flexibility were higher than those in the quitter group(t=13.69,4.58,5.75;P<0.01);the treatment outcome and social function of the complete group were also better than those in the quitter group(t=24.36,30.18,6.97;P<0.001);(2) The cognitive function of the subjects such as response inhibition and cognitive flexibility were significantly correlated with social support(r=-0.31,-0.29;P<0.01);(3)Logistic regression analysis showed that cognitive function including response inhibition,risk decisionmaking and cognitive flexibility was one of important factor to influence the methadone treatment outcome(B=-0.98,0.72,-0.63;P<0.05).Conclusion:Neurocognitive function is an important factor affecting the methadone maintenance treatment outcome.Cognitive function training can be considered as a support strategy for drug addiction treatment.

关 键 词：海洛因 药物成瘾 神经认知功能 美沙酮维持治疗 预测作用 

分 类 号：R749.05[医药卫生—神经病学与精神病学]