酒依赖复饮的风险因素及其与认知功能关系的研究

  目的  探讨酒依赖复饮的风险因素，并对酒依赖复饮患者认知功能进行评估，探讨认知功能损害与复饮的关系。  方法  选取2018年6月—2019年6月在杭州市第七人民医院行戒酒治疗的酒依赖患者85例为研究对象，根据戒酒后1年内是否再次出现酒依赖分为复饮组(52例)和非复饮组(33例)，对2组患者执行功能、记忆功能和注意力进行比较，以分析酒依赖复饮的危险因素。  结果  复饮组和非复饮组患者治疗前日饮酒量、婚姻状况、伴情感症状等比较差异具有统计学意义(均P < 0.05);复饮组患者在情感表达、亲密度、独立性、组织性、控制性和娱乐性方面明显低于非复饮组患者(均P < 0.05);复饮组患者戒断期间威斯康星卡片分类测试(WCST)应答总数、完成分类数、正确应答数明显低于非复饮组患者(均P < 0.05);复饮组患者言语记忆测验(S/VM)、空间广度测验(SS)和数字序列测验(DS)评分明显低于非复饮组患者(均P < 0.01)，而视觉记忆测验(VM)评分与非复饮组患者比较差异无统计学意义(P>0.05);复饮组患者在注意力数字广度测验(DST)、持续操作能力测验(CPT-IP)评分方面明显低于非复饮组患者(均P < 0.01);非条件logistic回归分析显示，饮酒量越多、伴情感症状、独立性和亲密度越低、控制性和组织性越差、注意力和执行能力越弱是造成酒依赖复饮的危险因素。  结论  既往日饮酒量大、伴随情感症状、家庭环境缺乏组织性、独立性和亲密度及缺乏执行力和注意力是影响患者复饮的危险因素，临床需加以关注。 

The risk factors and correlation with cognitive function for relapse of alcohol dependence

  Objective  To investigate the risk factors of alcohol dependence and to evaluate the cognitive function of patients with alcohol dependence and to explore the relationship between cognitive function impairment and rehydration.  Methods  Total 85 patients with alcohol dependence who were given abstinence treatment in Hangzhou Seventh People's Hospital from June 2018 to June 2019 were selected as the research objects. According to whether alcohol dependence occurred again within one year after abstinence, they were divided into the relapse group (52 cases) and the non-relapse group (33 cases). The executive function, memory function and attention ability of the two groups were compared to analyze the risk factors of alcohol dependence relapse.  Results  There were statistically significant differences between the relapse group and the non-relapse group in terms of alcohol consumption, marital status and emotional symptoms before treatment (all P < 0.05). The emotional expression, intimacy, independence, organization, control and entertainment of the patients in the relapse group were significantly lower than those in the non- relapse group (all P < 0.05). The total number of executive forces WCST responses, the number of completed classification and the number of correct responses in the relapse group were significantly lower than those in the non-relapse group (all P < 0.05). The scores of memory S/VM, SS and DS in the relapse group were significantly lower than those in the non- relapse group (all P < 0.01), while there was no significant difference between the VM scores and those in the non- relapse group (P>0.05). The scores of attention DST and CPT-IP were significantly lower in the rehydration group than those in the non-rehydration group (all P < 0.01). Non-conditional logistic regression analysis showed that higher alcohol consumption, associated emotional symptoms, lower independence and affinity density, poor control and organization, and poor attention and executive ability were risk factors for alcohol dependence.  Conclusion  Heavy drinking, emotional symptoms, lack of organization in family environment, independence and affinity, lack of executive ability and attention are risk factors affecting patients' relapse, which should be paid attention to clinically.