不同吸毒方式海洛因依赖者戒毒的调查与分析

海洛因依赖者在戒毒过程中 ,由于吸毒方式、身体状况、临床表现以及戒断反应等不同 ,治疗效果有所不同 ,根据不同状况配合治疗、护理 ,对于海洛因依赖者戒毒成功与否非常重要。为此 ,我们调查了 10 0例戒毒者 ,并对有关资料进行分析。1　对象与方法1.1　调查对象　随机调查 1996年间入住广州市精神病医院戒毒研究所的戒毒者 10 0例 ,符合《中国精神疾病分类方案与诊断标准》关于海洛因依赖诊断标准 ,入院后尿吗啡定性试验阳性。1.2　调查工具与方法　使用自编调查表 ,内容包括 :吸毒方式、并发症、戒断反应程度、对家属态度、对治疗合作程度…     

海洛因依赖者骨代谢的变化

目的:观察海洛因依赖者戒毒前、后的骨代谢变化情况。方法:采用RIA和ELISA法测定53例吸毒患者戒毒前、后及61名健康体检者血清中瘦素、骨钙素、Ⅰ型胶原吡啶交联终肽(ICTP)的浓度,并比较前后骨代谢指标的变化。结果:海洛因依赖者戒毒前血清瘦素水平显著高于戒毒后,并且两者均显著高于正常对照组(P<0.001);戒毒前、后血清BGP水平差异无显著性,但两者均显著高于正常对照组;3组间ICTP差异无显著性(P>0.05)。结论:海洛因依赖者存在骨代谢的改变,其骨形成及骨转换率有一定的影响,戒毒后仍不能完全恢复,而对骨吸收影响不大。提示在进行戒毒治疗的同时,要注意监测骨代谢的变化,并了解其变化规律,以利综合治疗。     

毒品依赖者继发脱髓脑病的CT表面及临床分析

目的：加深对脑脱髓鞘疾病的CT影像认识。材料与方法：5个毒品依赖者,1个在吸毒期间、4个在戒毒后出现脑神经症状和体征来进行CT检查,分析其CT征象及临床资料。结果：5个毒品依赖者表现不同部位、不同程度对称性脑白质脱髓鞘。结论：毒吕依赖者是可以继发脑脱髓鞘疾病的,特别是在戒毒后,其发病机制可能与自身免疫反应有关。     

住院管理及护理在自愿戒毒的海洛因依赖者中的实施效果

[目的]探讨住院管理及护理在自愿戒毒的海洛因依赖者戒毒治疗中的实施效果。[方法]选取2015年3月—2019年3月来我院自愿戒毒的56例海洛因依赖者作为研究对象,采用随机数字表法将其分为对照组和试验组各28例。对照组给予常规药物治疗和健康宣教,试验组在对照组基础上实施住院管理及护理。于干预前、干预后3个月、干预后6个月评估两组海洛因依赖者的海洛因渴求情况和整体健康状况。[结果]干预后,试验组海洛因渴求问卷得分低于对照组,健康状况调查问卷得分高于对照组,两组比较差异均有统计学意义(均P0. 05)。[结论]在常规药物治疗和健康宣教基础上对海洛因依赖者实施住院管理及护理有利于减轻海洛因依赖者对海洛因的渴求程度,改善海洛因依赖者的健康状况。     

攀枝花市彝族和汉族吸毒人员流行病学差异比较

目的比较分析攀枝花市彝族和汉族海洛因依赖者的流行病学差异。方法采用问卷调查方式随机抽取2007年1月1日至2008年1月1日进入攀枝花市某戒毒所和本院自愿戒毒治疗的海洛因依赖者共258例，其中彝族128例，汉族130例，进行访谈，记录访谈情况，进行横断面研究。结果彝族和汉族吸毒者在婚姻状况、文化程度、家人多人滥用尤其是夫妻双方吸毒、滥用药物、滥用药物的资费来源上差异有统计学意义。结论彝族和汉族海洛因依赖者有不同的流行病学特点，禁毒重在预防，应对不同人群实施不同的防治措施。     

美沙酮联合氯硝西泮治疗海洛因依赖的临床对照研究

目的探讨美沙酮联合氯硝西泮治疗海洛因依赖的疗效及安全性。方法将60例自愿戒毒的海洛因依赖者随机分为研究组30例和对照组30例。分别于治疗前及治疗后采用汉密尔顿焦虑量表和副反应量表评定临床疗效和不良反应。结果两组治疗前后汉密尔顿焦虑量表评分比较有非常显著性差异（P〈0.01）。结论美沙酮联合氯硝西泮治疗海洛因依赖疗效肯定,安全性高。     

吸毒损害肝脏360例观察与分析

吸毒损害肝脏３６０例观察与分析王兴星吸毒对肝脏的危害已被公认，本文通过吸毒者与对照组对比及吸毒者不同吸毒方式之间的对比分析，进一步证实吸毒的危害及不同吸毒方式对肝脏损害的差异．１资料与方法１．１一般资料本文３６０例均为自愿入所的海洛因依赖者，全部符合...     

100例海洛因依赖者常见并发症的调查分析

目的了解海洛因依赖者常见并发症。方法对100例自愿戒毒的海洛因依赖者进行面谈,将其首次滥用海洛因的年龄、滥用年限、日滥用量以及滥用海洛因后躯体状况,分别给予记录,并就日滥用量,滥用年限与性别方面分别与各并发症进行统计学分析。结果体质量减轻56例、消化系统并发症51例、便秘47例、口腔并发症46例、呼吸系统并发症40例。不同滥用年限便秘发生率有显著性差异(P<0.05),滥用年限长者便秘发病率高;不同日滥用量呼吸系统并发症发生率有显著性差异(P<0.05),日滥用量大者易并发呼吸系统疾病;不同性别体质量减轻有显著性差异(P<0.05),男性体质量减轻较女性明显。结论在戒毒过程中,护理人员应根据病人的躯体状况,针对性地采取有效的护理措施,以解除戒毒者的躯体疾苦,促进康复。     

男性海洛因依赖者的心理防御机制

目的:了解海洛因依赖者的心理防御机制,为减少吸毒及增加戒毒的成功率提供参考。方法:采用防御方式问卷对在北京市安康医院住院的自愿戒毒者50例(尿检阳性,符合美国精神疾病诊断标准III-R海洛因依赖者的诊断标准,至少3名家属或朋友证明其无药物滥用、依赖及精神病史)与其伴诊的同伴50例进行测查。结果:海洛因依赖者在运用不成熟的心理防御机制(5.0±2.5)、被动攻击(5.1±1.0)、幻想(6.6±1.8)、分裂(5.2±1.0)、退缩(12.4±4.2)高于对照组,差异有显著性意义(t=2.249～3.508,P=0.000～0.027);海洛因依赖组在成熟的防御机制(4.9±0.7)、升华(5.2±1.1)、幽默(4.1±1.2)低于对照组,差异有显著性意义(t=-0.297,2.100,0.836;P=0.7676,0.038,0.405);两组的中间型防御机制差异无显著性意义;海洛因依赖组的掩饰因子(6.4±1.1)高于对照组,差异有显著性(t=7.171,P<0.001)。结论:海洛因依赖者多采用不成熟的心理防御机制,善于运用掩饰。     

100例脱毒病人出院后复吸问题调查分析

当吸毒者陷入"毒海"的深渊不能自拔时,整个生活转向以海洛因为中心,家庭功能、职业功能、社会功能等开始明显受到影响.在家庭、单位、朋友、社会领域和自己内心的压力下,吸毒者或因吸毒行为暴露,或为了怕吸毒行为暴露而开始寻求戒毒治疗,开始打算或决定戒毒.因此,此时的海洛因依赖者,无论是从自己的内心来说,还是由于外界压力的作用,他们都是想要戒毒或被迫戒毒的.可以说,此时的海洛因依赖者非常清楚,除了对"快感"的渴求外,是没有任何一种理由(内心的和外界的)支持他们吸毒的.在这种来自外界和内心的种种压力下,绝大多数海洛因依赖者是会真心选择戒毒的.     

Plasma gamma-glutamyl transpeptidase in heroin addicts.

Plasma gamma-glutamyl transpeptidase was measured in 25 heroin addicts. The purpose was to find out if the long term administration of heroin would lead to a stimulation of GGTP due to the detoxication of this drug in the endoplasmatic reticulum of the liver. In 10 patients the elevation of GGTP could be attributed to liver damage, since other liver enzymes were also increased. 15 patients had normal GGTP activities, in 4 of them accompanied by minor elevations of single other hepatic enzymes. In 11 patients the GGTP activity as weel as that of the other enzymes was normal despite heavy chronic herioin abuse. It is therefore improbable that GGTP can be used to diagnose abuse of this drug and to evaluate the progress of drug detoxication treatments and drug abstention as has been proposed in chronic alcoholism.     

Addiction related alteration in resting-state brain connectivity

It is widely accepted that addictive drug use is related to abnormal functional organization in the user's brain. The present study aimed to identify this type of abnormality within the brain networks implicated in addiction by resting-state functional connectivity measured with functional magnetic resonance imaging (fMRI). With fMRI data acquired during resting state from 14 chronic heroin users (12 of whom were being treated with methadone) and 13 non-addicted controls, we investigated the addiction related alteration in functional connectivity between the regions in the circuits implicated in addiction with seed-based correlation analysis. Compared with controls, chronic heroin users showed increased functional connectivity between nucleus accumbens and ventral/rostral anterior cingulate cortex (ACC), between nucleus accumbens and orbital frontal cortex (OFC), and between amygdala and OFC and reduced functional connectivity between prefrontal cortex and OFC and between prefrontal cortex and ACC. These observations of altered resting-state functional connectivity suggested abnormal functional organization in the addicted brain and may provide additional evidence supporting the theory of addiction that emphasizes enhanced salience value of a drug and its related cues but weakened cognitive control in the addictive state.     

Alterations in the processing of non-drug-related affective stimuli in abstinent heroin addicts

Long-term exposure to drug may alter the neural system associated with affective processing, as evidenced by both clinical observations and behavioral data documenting dysfunctions in emotional experiences and processing in drug addicts. Although many imaging studies examined neural responses to drug or drug-related cues in addicts, there have been few studies explicitly designed to reveal their neural abnormalities in processing non-drug-related natural affective materials. The present study asked abstinent heroin addicts and normal controls to passively view standardized affective pictures of positive, negative, or neutral valence and compared their brain activities with functional MRI. Compared to normal controls, addicts showed reduced activation in right amygdala in response to the affective pictures, consistent with previous reports of blunted subjective experience for affective stimuli in addicts. Furthermore, in two visual cortical areas BA 19 and 37, while the controls showed greater responses to positive pictures than to negative ones replicating literature findings, the addicts showed the opposite pattern. The results reveal a complex pattern of altered processing of non-drug-related affective materials in addicts showing both heightened and blunted neural responses in different brain regions and for different stimulus valence. The present study highlights the importance of brain imaging research on drug addicts' processing of affective stimuli in understanding disruptions in their emotion circuitry.     

美沙酮维持治疗患者滥用苯二氮卓类药物调查与护理

目的:调查美沙酮维持治疗者滥用苯二氮卓类药物的发生率及相关因素。方法:对参加美沙酮维持治疗的海洛因依赖者进行尿苯二氮卓及吗啡检测,将苯二氮卓尿检结果与患者性别、婚姻状态、文化程度、滥用海洛因方式、年龄、海洛因滥用时间、美沙酮维持治疗剂量、参加美沙酮维持治疗的时间及尿吗啡检测结果等共九个因素进行Logistic回归分析。结果:共调查160例,尿苯二氮卓阳性率是8.1%,尿吗啡阳性率是36.3%,苯二氮卓阳性与吗啡阳性及注射使用海洛因相关(OR=27.328,P<0.005),与性别、年龄、海洛因依赖时间、服用美沙酮剂量等其他因素无相关性。结论:美沙酮维持治疗者存在滥用苯二氮卓类药物的现象,尤其是注射使用海洛因,并且在治疗期间仍滥用海洛因的患者。     

吸食海洛因所致脑白质病变的CT表现（附10例分析）

目的：探讨吸食海洛因脑白质病变的CT表现特点,方法：回顾性分析10例吸食海洛因患者的脑部CT表现,结果：7例均有双侧大球脑白质对称性广泛性密度减低,双侧基底节内囊后肢及小脑半球脑白质对称性密度减低,2例表现为基底节内囊后肢及小脑半球脑白质对称性密度减低,1例表现为小脑半球脑白质对称性密度减低。结论：大脑及小脑半球脑白质,基底节区对称性密度减低是吸食海洛因所致脑白质病变特征性CT表现,尤以小脑改变最明显。     

海洛因白质脑病的CT诊断

目的：探讨海洛因白质脑病的CT特点及CT对本病的诊断价值。方法：回顾分析10例海洛因引起的白质脑病的CT表现与临床资料，男6例，女4例，年龄13-38岁。有吸毒品海洛因史2-4年。其中5例做了增强CT扫描。结果：海洛因白质脑病的CT表现为小脑齿状核、大脑后部脑白质、内囊后肢、胼胝体压部、大脑脚、中脑、桥脑对称的低密度影8例，以小脑损害为重，小脑中线两侧对称性边界的类圆形蝴蝶样病灶为特征。其中2例表现为双侧豆状核、内囊区对称性低密度灶。增强扫描无强化。结论：海洛因海绵状白质脑病的CT表现有特征性，CT对本病诊断有重要价值。     

Suppressed prolactin response to dynorphin A1-13 in methadone-maintained versus control subjects

Dynorphin A1-13, a shortened sequence of the natural peptide dynorphin A1-17, is a primarily kappa-opioid receptor-preferring peptide. Previously, we showed that dynorphin A1-13 administered to normal volunteers causes a prompt dose-dependent elevation in serum prolactin that may reflect a reduction in tuberoinfundibular dopaminergic tone. This study was conducted to determine whether tuberoinfundibular dopaminergic tone is reduced in methadone-maintained patients. Eight former heroin addicts on stable-dose methadone maintenance with no ongoing drug or alcohol abuse or dependence and 15 normal volunteer controls with no history of drug or alcohol dependence received dynorphin A1-13 intravenously at doses of 120 microg/kg and 500 microg/kg. Studies began one hour before methadone dosing to avoid the expected increase in prolactin that coincides with peak plasma levels of methadone. After intravenous dynorphin A1-13, a dose-response increase in serum prolactin, which peaked within 20 min, was observed in both groups. There was no difference in prolactin between the two groups at baseline or following a placebo. The prolactin response to each dose of dynorphin A1-13 was significantly lower in the methadone-maintained volunteers compared with the controls. These results suggest that tuberoinfundibular dopaminergic tone is altered in methadone-maintained subjects. It is unknown whether altered dopaminergic tone existed before opiate addiction, is a result of heroin addiction, or is reflective of methadone maintenance. Whether methadone-maintained subjects also have decreased dopaminergic response to dynorphin and other kappa-opioid receptor ligands in mesolimbic-mesocortical and nigrostriatal dopaminergic systems cannot be determined from this study.     

脑外伤患者99Tcm-ECD SPECT显像的影像特征和应用价值

目的　探讨99Tcm 双胱乙酯 (ECD)SPECT局部脑血流显像在各类脑外伤的影像特征和应用价值。方法　正常对照组 10例 ,脑外伤组 2 4例。病员准备、采集条件和图像处理基本同常规脑血流灌注断层显像。所有患者均进行同期CT扫描。结果　 2 4例脑外伤患者中 2 0例SPECT表现为异常 ,病灶累及脑的部位 71个 ,阳性率 83 % ,CT阳性率为 71%。SPECT发现病灶范围和数目均高于CT。各类脑外伤SPECT除表现为局限性放射性稀疏或缺损的共同特点外 ,不同类型脑外伤还具有各自相应的影像特征 ,如脑挫裂伤表现为假性结构紊乱 ;脑血肿清除术后表现为原血肿区缺损 ,酷似脑梗塞改变。结论　各类脑外伤患者SPECT脑灌注显像具有相应的影像特征 ,该显像具有重要临床价值。     

DCC、FAT3、DLG2、KTN1基因多态性与海洛因依赖的相关性研究

目的探讨结肠癌缺失基因(DCC)、非典型钙黏蛋白3基因(FAT3)、成虫大盘基因同源物2(DLG2)和驱动结合蛋白1基因(KTN1)4个单核苷酸多态性(SNP)位点与海洛因依赖之间的关系。方法采用SNaPshot SNP分型技术对396例海洛因依赖患者(海洛因依赖组)及401例健康对照者(健康对照组)DCC(rs2270954)、FAT3(rs1318862)、DLG2(rs683250)和KTN1(rs945270)位点进行基因分型,比较两组间各位点等位基因、基因型频率的差异,同时利用多维因子降维法(MDR)和二元Logistic回归分析4个位点基因间交互作用。结果DCC(rs2270954)位点及KTN1(rs945270)位点的等位基因和基因型频率在健康对照组和海洛因依赖组间差异有统计学意义(P<0.05),携带DCC(rs2270954)A等位基因及KTN1(rs945270)C等位基因的个体发生海洛因依赖的可能性更高。此外,DCC(rs2270954)与KTN1(rs945270)位点间存在显著二维基因交互作用,提示二者可能通过上位效应影响DCC和KTN1的表达水平,进而异常调节中脑边缘奖赏系统,产生海洛因依赖。结论DCC(rs2270954)及KTN1(rs945270)位点基因多态性可能与海洛因成瘾有关,且二者可能通过交互作用影响大脑奖赏效应的调节。