中国科学院心理研究所机构知识库

背景：长效纳曲酮缓释剂临床应用近1年后,若干报道结果证明患者情绪状态改善,心瘾减退,希望进一步探寻长效纳曲酮缓释剂戒毒对记忆力恢复的神经心理学证据。目的：观察长效纳曲酮缓释剂治疗对阿片类药物依赖者词语记忆能力的影响。设计、时间及地点：对比观察实验,于2006-10/12在湖北省武汉市公安戒毒所、湖南省常德市、河南省郑州市和广东省阳江市各地自愿戒毒所完成,健康对照组测试于2006-10在北京大学深圳医院完成。对象：男性阿片依赖综合征患者88例,包括长效纳曲酮缓释剂治疗组35例,强制戒毒组26例,未治疗组27例,另选择22名健康志愿者作为对照组。方法：长效纳曲酮缓释剂治疗组在测试前6-12个月腹壁两侧皮下植入长效纳曲酮缓释剂3.1g,强制戒毒组接受全封闭强制戒毒6个月,至测试之日止现场进行尿液海洛因、美沙酮和丁丙诺啡定性检测全部为阴性。采用便携式事件相关电位工作系统于各戒毒所现场采集记录3组不同戒毒方式治疗的阿片类药物依赖患者以及健康对照组完成新旧词语再认记忆任务时脑电事件相关电位及事件相关电位的波形。主要观察指标：对词语记忆的正确率和反应时,语言相关电位-N400的潜伏期和波幅。结果：①3组患者对词语记忆的正确率和反应时与健康对照组比较差异有非常显著性意义（P〈0.001）;长效纳曲酮缓释剂治疗组词语记忆正确率提高,反应时缩短,与强制戒毒组和未治疗组比较差异有显著性（P〈0.05）。②3组患者完成词语记忆的N400潜伏期比健康对照组显著延长（P〈0.01）;长效纳曲酮缓释剂治疗组其N400的波幅提高,与健康对照组比较差异无显著性（P〉0.05）,与强制戒毒组和未治疗组相比差异有显著性意义（P〈0.01）。结论：长效纳曲酮缓释剂治疗能有效改善阿片类药物依赖者神经系统的功能,提高患者的词语记忆能力。

BACKGROUND： Long-term sustained release naltrexone has been reported in clinical application near one year that it can improve emotional state and relieve addiction; therefore, the effect of long-term sustained release naltrexone on memory restoration at neuropsychology level were explored. OBJECTIVE： To observe the effect of long-term sustained release naltrexone on memory ability of opioid addicts. DESIGN, TIME AND SETTING： A contrast observational study was performed at Drug Rehabilitation Centers of Wuhan, Changde, Zhengzhou, and Jiangyang between October and December 2006. Healthy controls were tested in Shenzhen Hospital of Peking University in October 2006. PARTICIPANTS： A total of 88 males with opioid addicts were divided into naltrexone group （n=35）, compulsory detoxification group （n=26）, and non-treatment group （n=27）. Another 22 healthy subjects were considered as the controls. METHODS： At 6-12 months before testing, naltrexone （3.1 g） was subcutaneously implanted into bilateral abdominal wall in the naltrexone group; patients in the compulsory detoxification group underwent completely compulsory detoxification for 6 months, and the examination results, including diamorphine, methadone, and buprenorphine in urine, were negative on the immediately testing day. Event related potential and its wave form were recorded from the opioid addicts in the three groups and from healthy controls who finished semantic recognition between new and old words using portable-type event related potential working system. MAIN OUTCOME MEASURES： Correct rate and response time of semantic memory; latency and amplitude of language related potential-N400. RESULTS： ①There were significant differences in correct rate and response time between three experimental groups and healthy control group （P 〈 0.001）; in addition, correct rate was significantly increased, and response time was significantly shortened in the naltrexone group compared to compulsory detoxification group and non-treatment group （P〈 0.05）. ② N400 latency in the three experimental groups was significantly longer than healthy control group （P 〈 0.01）, while N400 amplitude in the naltrexone group was increased, which was no significant difference compared to healthy control group （P〉 0.05） but was significant difference compared to compulsory detoxification group and non-treatment group （P 〈 0.01 ）. CONCLUSION： Long-term sustained release naltrexone can effectively improve neural function and enhance semantic memory of the opioid addicts.

广东省科技计划项目(2004B3600105) 广东省医学科学基金项目(A2007592)~~