丁丙诺啡舌下片合并东莨菪碱、异丙嗪静脉注射对认知功能的影响

目的:了解丁丙诺啡舌下片合并东莨菪碱、异丙嗪静脉注射(简称“1+1”)对认知功能的影响。方法:对60例“1+1”滥用者、60例海洛因依赖对照者采用韦氏记忆量表、Stroop测验以及威斯康星卡片分类测验工具,分别对其记忆、注意和执行功能进行测试。结果:“1+1”滥用组的记忆商数(76·78±s18·62)明显低于海洛因对照组(95·67±s14·62),尤其以视觉再认、图片回忆、视觉再生、触摸记忆、理解记忆和背诵数目为甚(P<0·001);“1+1”滥用组的Stroop(C、CW)总时间、ST-C中不正确数和纠正数高于海洛因对照组,差异有显著性(P<0·01);“1+1”滥用组的WCST-M测验的分类错误数、持续错误总数高于海洛因对照组,正确分类个数低于对照组,差异有统计学意义(P<0·05)。结论:“1+1”滥用者在使用上述药物后,即使未再使用海洛因,但认知损害仍在继续加重,主要表现为大脑记忆、注意和执行功能方面存在不同程度的损害。

EFFECT OF INTRAVENOUS ABUSE OF BUPRENORPHINE TABLETS, SCOPOLAMINE AND PROMETHAZINE ON COGNITIVE FUNCTION

Objective:To investigate the effect of intravenous abuse of buprenorphine tables,scopolamine and promethazine,which was abbreviated to be “1+1” abuse in China,on the cognitive function of its abusers. Methods:Cognitive function of 60 “1+1” abusers and 60 heroin addicts as control was assessed with a battery of neuropsychological evaluation instruments in Changsha,China. The tools included Wechsler Memory Scale-revised test (WMS),Stroop Test (C, CW) and Modified Wisconsin Card Sorting Test (WCST-M). Results:The memory quotient and the scores on such factors as vision recognition,picture recall,design reproduction,touch memory, story recall as well as digit span of the “1+1” abusers(76.78±s 18.62) were significantly lower than those of the heroin addicts control group (95.67±s 14.62) , P<0.001. There was significant difference between the two groups in the time spent in Stroop test (C, CW),the number of errors and rectification in Stroop-C test, with the “1+1” abusers spending more time in Stroop test (C, CW), and having more errors and rectification in Stroop-C test.(P<0.01) Furthermore,the “1+1” abusers had more scores in total,persistent errors, and lower number of categories in WCST,showing statistical significant difference (P<0.05). Conclusion: Certain cognitive dysfunction, such as memory, attention and executive function is observed in the “1+1” abusers in our objects. The impairment of cognitive function, which has been caused by heroin abuse,continue to aggravate,even if the“1+1” abusers only use the intravenous form of buprenorphine tables,scopolamine and promethazine,while keeping ABSTinence to heroin.