环境线索对戒断期海洛因依赖者神经电生理的影响

Objective To explore the changes of craving and neuro-electrophysiological reactions under the exposure of heroin-related cues in abstinent heroin dependents.Methods In this self-controlled study,382 abstinent heroin dependent patients watched video of heroin smoking and injecting situations,and in the meantime were exposed to herein simulacrum and apparatus after relaxation exercises.The neuroelectrophysiological reactions were mcagured with a multi-biofeedback instrument before and after the cue exposed.Self-reported craving was also assessed before and after cue exposed.Results The craving were increased[(18±22)mm vs.(29±29)mm,P＜0.01]after cue exposures compared to pre-exposure,EMG[(12±7)μN vs.(14±10)μV,P＜0.01]and SC[(6.8±4.3)μS vs.(7.4±4.3)μS,P＜0.01]also increased.But the percentages of δ,θ,α,SMR,low β,high β decreased compared to that under the cue exposures[8:(10.8±4.7)%vs.(9.7±4.4)%,P＜0.01;0:(6.8±2.0)%vs.(6.3±2.0)%,P＜0.01;α:(4.8±1.8)%vs.(4.5±1.7)%,P＜0.01;SMR:(3.0 ±1.2)%vs.(2.8±1.2)%,P＜0.01;low β:(2.6±1.1)%vs.(2.5±1.1)%,P＜0.01 and high β:(4.6 ±1.5)%vs.(4.5±1.5)%.P＜0.05].Conclusions The results indicate that drug-related cue induce heroin craving and electrophysiological reactions.     

海洛因依赖者戒毒中应用护理程序的研究

目的:探讨护理程序对戒毒病人的护理模式,以促进病人积极参与戒毒,减轻戒断症状及改善吸毒导致生理、心理、社会的危害。方法:对应用护理程序工作方法的护理效果进行SPSS11.5统计分析。结果:开展后住院病人意外事件及暴力行为的发生率比开展前显著性降低,实施心理卫生教育后病人对毒品危害性及相关知识认识水平显著提高。结论:通过应用护理程序的工作方法能帮助病人进步且朝向预定目标,为病人走上康复之道打下基础。     

Fixed-interval schedules for drug self-administration in the rat

The practicality of using second-order fixed-interval schedules in studies of heroin reinforcement with rats was examined. Optimum rates of responding were obtained with a dose of 0.03 mg/kg/infusion and an interval duration of 3 min. In addition, schedules consisting of a only a single interval were shown to be practical, leading to response rates comparable to those obtained with cocaine or food as reinforcer.The views expressed in this publication are those of the author and do not necessarily represent those of the Addiction Research Foundation     

Heroin self-administration in rats under a progressive ratio schedule of reinforcement

Heroin self-administration behavior under a progressive ratio (PR) schedule of reinforcement was evaluated in rats. The schedule was designed to restrict drug intake, minimize opiate dependency, and quantify the number of responses emitted (final response ratio) in order to receive a limited number of heroin infusions. Final ratios were found to be stable and did not increase with chronic (31 days) PR reinforcement. The ability of the PR schedule to detect changes in heroin reinforcement was demonstrated by evaluating the effect of naltrexone pretreatment and unit dose alteration on final ratios. Naltrexone (0.4 mg/kg) reduced final ratios and an inverted U dose-response relationship was established for the unit heroin doses 12.5–100 µg/injection. Maximal final ratios occurred with 50 µg/injection heroin reinforcement. This PR schedule may provide a useful method for evaluating the effects of pharmacological manipulations or lesions on opiate reinforcement.     

海洛因成瘾大白鼠中脑腹侧被盖区超微结构变化的研究

目的　模仿人类吸毒成瘾方式建立海洛因成瘾动物模型 ,研究其中脑腹侧被盖区超微结构改变 ,为深入研究海洛因成瘾神经生物学、行为学、神经药理学、成瘾戒断治疗等奠定基础。方法　采用递增法人为建立海洛因成瘾动物模型 ,设立对照组和模型组 ,取两组动物中脑腹侧被盖区于电镜下观察超微结构改变。结果　海洛因成瘾大白鼠中脑腹侧被盖区神经元胞体、轴突、树突都出现变性、坏死、调亡等超微病理结构改变。正常对照组电镜超微影像正常。结论　海洛因成瘾大鼠脑组织出现广泛性、多发性损害 ,且以变性为主 ,神经元凋亡是海洛因成瘾致脑神经元死亡的主要形式。     

海洛因依赖伴发意识障碍与苯二氮滥用关系

目的了解海洛因依赖者脱毒时伴发意识障碍与苯二氮     

海洛因依赖者的个性心理特征及其对复吸的影响分析

目的了解自愿戒毒的海洛因依赖者的个性心理特征及其对脱毒后复吸的影响。方法使用MMPI对30例自愿戒毒的海洛因依赖者和30例未对任何药物成瘾的正常人的个性心理特征进行对照分析，明确海洛因依赖者个性心理特征，在此基础上找出个性心理特征与复吸原因的联系。结果海洛因依赖者在MMPI各量表中诈病(F)，精神病态(Pd)，疑病症(Hs)，偏执狂(Pa)，精神分裂(Sc)等量袁与对照组有明显的差异，且这些差异与脱毒者复吸原因有着直接的关系。结论海洛因依赖者的个性心理特征为明显的反社会行为和社会适应障碍，对自己健康过分关注，缺乏对社会环境的归属感，易将自己的问题合理化而归因于剐人，并由这种心理特征增加了复吸率。     

静脉内毒瘾者HIV感染的转归及影响因素

对ＨＣＶ血清标记阳性的静脉内毒瘤者进行半年和１５个月随访，并调查影响转归的部分因素。结果显示，静脉内毒瘾者抗－ＨＣＶ自然转阴率分别为１１．０／和３３．３％。单因素和多因素分析均提示转阴率以婚姻状况良好的已婚者较离婚者高、人均年收入高者较低者高，说明婚姻状况和人们的经济水平对毒瘾者抗－ＨＣＶ转阴有一定的影响。     

海洛因依赖者前额叶皮质及杏仁核1H-MR波谱研究

Objective To explore the characteristic findings of 1H-MR spectroscopy(1H-MRS) in the prefrontal cortex and amygdala of patients with heroine dependence(HD), and the relationship to total cumulative dose of inhaled heroine.Methods Fourteen male HD patients and 12 healthy controls (HC) underwent 1H-MRS at the prefrontal cortex and amygdala regions.The total cumulative in haled heroin dose was (852±341) g in HD.Ratios of N-acetylaspartate/creatine(NAA/Cr) and choline/creatine (Cho/Cr) were respectively measured in the prefrontal cortex and bilateral amygdale regions.The student's t test and the linear correlation were employed for statistical analysis.Results Compared to HC group, HD patients had a significant lower ratio of NAA/Cr in the prefrontal cortex (1.44±0.46 vs 1.50±0.75, t=1.77 ,P <0.05), left amygdala region (1.32±0.08 vs 1.42±0.08, t=3.41, P < 0.05), and right amygdala region (1.34±0.09 vs 1.44±0.10, t=2.63, P <0.05), the HD patients had a significant increased ratio of Cho/Cr in the prefrontal cortex (0.92±0.06 vs 0.86±0.08, t=2.31, P < 0.05), left amygdala region (1.20+0.12 vs 1.07±0.04, t=3.60,P<0.05) and right amygdala region(1.26±0.15 vs 1.12±0.11,t=2.60,P <0.05).There was a negative linear correlation between the total cumulative inhaled heroine dose and the ratio of NKA/Cr in the prefrontal cortex (r=-0.9159, P < 0.01), left amygdala region (r=-0.8756, P < 0.01), and right amygdala region (r=-0.9399, P < 0.01) respectively.Conclusions The study indicates that neuronal damage and glial proliferation may occur in the prefrontal cortex and amygdala region, which suggests the abnormalities of executive function and emotion in patients with HD.A relationship exists between the heroin-induced metabolic abnormality and the total cumulative dose of inhaled heroine.     

对海洛因依赖者心理健康与应对方式的研究

目的了解海洛因依赖者的心理健康状况及应对方式。方法对入组的60例吸毒者,在脱毒后、出所前、出所随访中作SCL-90和简易应对方式的测查,并与正常对照组比较分析。结果SCL-90和简易应对方式各因子均值比较,心理症状戒毒组比正常对照组高（P〈0.05）,积极应对戒毒组比正常对照组低（P〈0.05）,消极应对戒毒组比正常对照组高（P〈0.05）,消极应对与心理症状显著相关（P〈0.05）。出所前组与正常男性比较,仅其他因子（睡眠饮食障碍）戒毒者高（P〈0.05）。所外随访未复吸组与正常对照男性比较,无显著差异（P〉0.05）。回顾未复吸组在往所戒毒期间与正常对照男性比较,有躯体化、强迫、抑郁、焦虑、敌对、精神、其他7个因子和总均分有显著差异（P〈0.05）,17例复吸者作了同样的比较分析,除积极应对因子外,余因子均有显著差异（P〈0.05）。17例复吸者再入所时,各因子均值高于正常对照组（P〈0.05）。结论吸食海洛因成瘾可造成吸毒者心理健康状况恶化和应对方式不良,心理症状与消极应对方式相关,有诸多心理健康问题和对社会应激事件通常采用消极应对方式的戒毒者,其复吸的可能性要大。