男性酒依赖患者食欲素A与急性期戒断反应的相关性

目的探讨男性酒依赖患者血浆食欲素A(orexin-A,OXA)浓度与急性期酒精戒断反应、心理渴求之间的关系。方法纳入60例男性酒依赖患者和60名健康成年男性。收集一般人口学资料,检测血浆OXA浓度,以及总胆固醇、肌酸激酶、谷丙转氨酶、谷草转氨酶、血糖及血钾水平,使用修订版临床酒精戒断症状评估量表中文版(clinic institute alcohol withdrawal syndrome scale,CIWA-Ar)及视觉模拟量表(visual analogues scale,VAS)评估患者酒精戒断反应严重程度和心理渴求程度;患者组接受戒酒治疗14 d后,再次检测OXA及血生化指标,以及评估CIWA-Ar及VAS。结果入组时患者组血浆OXA、总胆固醇、肌酸激酶、谷丙转氨酶、谷草转氨酶及血糖水平高于对照组(均P<0.05),血钾浓度低于对照组(P<0.05)。在入组时患者组中轻度戒断反应者血浆OXA水平低于中度或重度戒断反应者(均P<0.05)。患者组治疗前后血浆OXA浓度、CIWA-Ar评分、VAS得分存在统计学差异(均P<0.05)。患者入组时血浆OXA的水平与CIWA-Ar评分(r=0.34,P<0.01)和VAS评分(r=0.47,P<0.01)均具有统计学相关性。结论在急性酒精戒断期男性酒依赖患者血浆OXA水平可能与戒断反应、渴求有关。

Association of Orexin-A and acute withdrawal reaction in male patients with alcohol dependence

Objective To explore the correlation between the change of orexin-A(OXA)concentration and the severity of acute withdrawal reaction and craving in patients with alcohol dependence.Methods Sixty male inpatients with alcohol dependence and sixty healthy adult males were included.Data on the general demographic statistics was collected.The laboratory tests were performed to examine total cholesterol level(TC),creatine kinase(CK),alanine transaminase(ALT),aspartate aminotransferase(AST),blood glucose,potassium and the plasma concentration of OXA in patients at the baseline and 14 days after treatment.The revised clinical institute withdrawal assessment for alcohol scale(CIWA-Ar)and the visual analogue scale(VAS)were used to evaluate the severity of acute withdrawal symptoms as well as craving at the baseline and after 14 days treatment.Results There were significant differences between patients and controls in OXA concentration,TC,CK,ALT,AST,blood glucose and potassium(all P<0.05)at the baseline.The levels of OXA were lower in mild withdrawal group than in moderate group or in severe group(all P<0.05)at the baseline.There were significant differences in plasma OXA concentration,CIWA-Ar score and VAS score before and after treatment in the patient group(all P<0.05).There presents a significant correlation of OXA with alcohol withdrawal symptom(r=0.34,P<0.01)and craving(r=0.47,P<0.01)in patients at the baseline.Conclusion The plasma concentration of Orexin-A is associated with withdrawal reaction and carving in male patients during the acute withdrawal period.