甲基苯丙胺及海洛因依赖者生理及心理因素相关分析  

Effects of physiological and psychological factors on craving in methamphetamine and heroin dependent patients

作　　者：任子旋 许华山 焦东亮 王文娟 王立金 朱宇琼 刘璐颖 凌强 石伟 徐玉林 宋莉 REN Zi-xuan;XU Hua-shan;JIAO Dong-liang;WANG Wenjuan;WANG Li-jin;ZHU Yuqiong;LIU Lu-ying;LIANG Qiang;SHI Wei;XU Yu-lin;SONG Li(School of Mental Health,Bengbu Medical College,Bengbu 233030,Anhui,China;Compulsory Isolated Drug Rehabilitation Center,Bengbu 233030,Anhui,China;The Fourth People′s Hospital,Bengbu 233030,Anhui,China)

机构地区：[1]蚌埠医学院精神卫生学院,安徽蚌埠233030 [2]蚌埠强制隔离戒毒所,安徽蚌埠233000 [3]蚌埠第四人民医院,安徽埠233030

出　　处：《中国药物依赖性杂志》2022年第6期475-480,486,共7页Chinese Journal of Drug Dependence

基　　金：蚌埠医学院研究生科研创新计划项目(Byycx20048);蚌埠医学院自然科学基金重点项目(2020byzd021);安徽省教育厅人文社科重点项目(SK2019A0181);安徽省教育厅自然科学重点项目(KJ2018A1017)。

摘　　要：目的探索甲基苯丙胺和海洛因依赖者执行功能、冲动性和心率变异性与健康人群的差异,及其与渴求的关系。方法从安徽省某强制戒毒所随机选取40例甲基苯丙胺依赖者,安徽某美沙酮门诊随机选取50例海洛因依赖者,同时招募相匹配的健康人群50例,采用执行功能行为评定量表成人版、Barratt冲动性量表、视觉模拟标尺评估心理指标,同时采用Spirit生物反馈系统测量生理指标。结果甲基苯丙胺依赖组在MI、BRI、GEC、运动冲动性、认知冲动性、无计划冲动性、总分、LFn、LF/HF得分显著高于健康对照组(P<0.05),HFn得分低于健康对照组(P<0.05);海洛因依赖组在MI、BRI、GEC、认知冲动性、无计划冲动性、总分、LFn得分显著高于健康对照组(P<0.05),HFn得分低于健康对照组(P<0.05);甲基苯丙胺依赖组与海洛因依赖组比较,甲基苯丙胺依赖组在BRI、运动冲动性、LFn、LF/HF得分高于海洛因依赖组(P<0.05),HFn得分显著低于海洛因依赖组(P<0.05)。通过相关分析和逐步回归分析显示,MI、BRI、GEC、无计划冲动性、平均心率、RMSSD与甲基苯丙胺依赖者渴求显著相关(P<0.05),BRI、GEC、运动冲动性、总分、RMSSD与海洛因依赖组的美沙酮使用量显著相关(P<0.05)。结论甲基苯丙胺和海洛因导致依赖者执行功能障碍、高冲动性以及心率变异性改变。执行功能、冲动性和心率变异性与对甲基苯丙胺依赖者的渴求和海洛因依赖者的美沙酮使用剂量相关,执行功能、冲动性和心率变异性有助于预测物质依赖者复吸情况。Objective To explore the differences in executive function,impulsivity,and heart rate variability in methamphetamine and heroin dependent individuals compared to healthy populations,and their relationship to craving.Methods Forty cases of methamphetamine dependents were randomly selected from a compulsory drug rehabilitation center in Anhui Province,and fifty cases of heroin dependents were randomly selected from a methadone outpatient clinic in Anhui Province,while fifty cases of matched healthy people were recruited.The Behavior Rating Inventory of Executive Function-Adult version,the Barratt Impulsiveness Scale,and the Visual Analogue Scale were used to assess psychological indicators,while the Spirit Biofeedback System was used to measure physiological indicators.Results The methamphetamine dependent group had significantly higher MI,BRI,GEC,motor impulsivity,cognitive impulsivity,unplanned impulsivity,total score,LFn,and LF/HF scores(P<0.05)and lower HFn scores(P<0.05)than the healthy control group;the heroin dependent group had significantly higher MI,BRI,GEC,cognitive impulsivity,unplanned impulsivity,total score,and LFn scores(P<0.05)and lower(P<0.05)HFn scores(P<0.05)than the healthy control group.When comparing with the heroin dependent group,the methamphetamine dependent group had higher BRI,motor impulsivity,LFn,and LF/HF scores than the heroin dependent group(P<0.05),and significantly lower HFn scores than the heroin dependent group(P<0.05).Correlation analyses showed that MI,BRI,GEC,unplanned impulsivity,mean heart rate,and RMSSD were significantly associated with craving in methamphetamine dependent individuals(P<0.05),and BRI,GEC,exercise impulsivity,total score,and RMSSD were significantly associated with methadone use in the heroin dependent group(P<0.05).Conclusion Methamphetamine and heroin cause executive dysfunction,high impulsivity,and altered heart rate variability in dependent individuals.Executive function,impulsivity,and heart rate variability affect methamphetamine craving and methadon

关 键 词：甲基苯丙胺 海洛因 执行功能 冲动 心率变异性 渴求 

分 类 号：R749[医药卫生—神经病学与精神病学]