CAJ | 학술논문

目的观察中国南方新近出现的盐酸丁丙诺啡舌下片合并东莨菪碱、异丙嗪药物依赖者(BSP依赖者)停药后脑白质完整性的动态变化.方法采用弥散张量成像(DTI)方法对16例BSP依赖者停药后第3天、第1个月以及第2个月各向异性分数(FA)进行了自身前后对比研究,并设立18例正常对照组.结果与正常对照组相比,停药3dBSP依赖者额叶(14,48.- 16；28,-26,46)、胼胝体(18,30,-14；- 14,26,-12)、顶叶(-50,-26,26)、颞叶(-46,-40,6；34,- 62,8)区域白质FA值显著性低于正常对照组(P＜0.001).与停药3d相比,BSP依赖者停药1个月白质FA值没有变化,停药后2个月部分脑区白质FA值有所增高,包括左侧额上回(-20,50,18)、右侧额中回(30,- 20,44)以及右侧顶下小叶(38,-30,34),差异有显著性(P＜0.001).对比停药2个月BSP依赖者与正常对照组,先前受损严重的脑区额叶、胼胝体、顶叶、颞叶区域白质FA值仍低于正常对照组(P＜0.01).结论 BSP滥用导致白质完整性的损害随着戒断时间的延长,前额叶等受损脑区在停药2个月后可得到部分恢复,但仍不能达到正常水平.
목적 관찰중국남방신근출현적염산정병낙배설하편합병동랑탕감、이병진약물의뢰자(BSP의뢰자)정약후뇌백질완정성적동태변화.방법 채용미산장량성상(DTI)방법대16례BSP의뢰자정약후제3천、제1개월이급제2개월각향이성분수(FA)진행료자신전후대비연구,병설립18례정상대조조.결과 여정상대조조상비,정약3dBSP의뢰자액협(14,48.- 16；28,-26,46)、변지체(18,30,-14；- 14,26,-12)、정협(-50,-26,26)、섭협(-46,-40,6；34,- 62,8)구역백질FA치현저성저우정상대조조(P＜0.001).여정약3d상비,BSP의뢰자정약1개월백질FA치몰유변화,정약후2개월부분뇌구백질FA치유소증고,포괄좌측액상회(-20,50,18)、우측액중회(30,- 20,44)이급우측정하소협(38,-30,34),차이유현저성(P＜0.001).대비정약2개월BSP의뢰자여정상대조조,선전수손엄중적뇌구액협、변지체、정협、섭협구역백질FA치잉저우정상대조조(P＜0.01).결론 BSP람용도치백질완정성적손해수착계단시간적연장,전액협등수손뇌구재정약2개월후가득도부분회복,단잉불능체도정상수평.
Objectives To explore the brain white matter integrity among the patients with buprenorphine tables,scopolamine and promethazine solution(BSP) dependence after abstinence.Methods BSP-dependent patients( n=16)and age/eduction-matched healthy control subjects ( n=18) were assessed by diffusion tensor imaging (DTI) after 3 days,1 month and 2 months of abstinence.White matter (WM) integrity was measured with DTI as fractional anisotropy ( FA),an index of intravoxel orientational coherence of white matter fibers.Results Compared with health controls,FA values were significantly lower in frontal,parietal,temporal and corpus callosum in the BSP addicts after 3-day withdrawal (P＜0.001,uncorrected).Increased FA values in left superior frontal cortex,right medial frontal gyms and fight inferior parietal gyrus were found in BSP users after 2 months of abstinence (P ＜0.001,uncorrected).However,no significant difference was found between these BSP addicts after 1-month abstince.Compared with health controls,BSP dependent subjects still exhibited significantly lower FA in the corpus callosum,frontal,parietal and temporal WM after 2-month withdrawal (P ＜ 0.001,uncorrected ).Conclusion The abnormalities showed less recovery in BSP dependent individuals with abstinence in white matter that suggests that rehabilitation time should be further prolonged for BSP addicts and emphasis cognitive-behavioral therapy to assist BSP abusers rebuild social functions.