海洛因依赖者和冰毒依赖者脑多巴胺转运体改变的研究

发布时间：2018-04-26 17:56

本文选题：海洛因 + 多巴胺转运体　；参考：《复旦大学》2013年硕士论文

【摘要】：第一部分海洛因成瘾者脑多巴胺转运体991Tc-TRODAT-lSPECT显像研究 [目的]应用99mTc-TRODAT-1SPECT显像技术,比较海洛因依赖者与正常志愿者纹状体内多巴胺转运体水平 [方法]招募21名健康志愿者(男14名,女7名)和23名海洛因依赖者(男18名,女5名)。海洛因依赖者生理性脱毒两周后进行心理渴求评分、汉密顿焦虑量表(HAMA)评分和汉密顿抑郁量表(HDMA)评分。所有受试者均为右利手,两组受试者年龄、BMI均无显著性差异。对健康志愿者和脱毒两周海洛因依赖者进行99mTc-TRODAT-1脑SPECT显像。对SPECT图像进行三维重建,参照正常人MRI图像相应横断面,在SPECT图像上对左侧纹状体、右侧纹状体、左侧尾状核、右侧尾状核、左侧壳核和右侧壳核进行ROI勾画,选取枕叶(OC)作为本底。计算的放射性摄取比值(Specific uptake ratios, SURs)=(ROI-OC)/OC。采用SPSS15.0软件,进行统计分析。 [结果]海洛因依赖者双侧纹状体、尾状核和壳核放射性摄取比值明显低于正常对照组(左侧纹状体：1.33±0.17和1.97±0.41,t=6.63,P0.001；右侧纹状体：1.28±0.19和1.99±0.39,t=7.55,P(0.001：左侧尾状核：1.32±0.16和2.01±0.42,t=7.13,P(0.001：右侧尾状核：1.27±0.19和2.05±0.41,t=7.87,P(0.001：左侧壳核：1.33±0.18和1.91±0.40,t=6.10,P0.001：右侧壳核：1.28±0.19和1.93±0.38,t=7.14,P0.001)。海洛因依赖者生理性脱毒两周后渴求、焦虑和抑郁评分平均值分别为：1.70±1.66,15.39±7.50和13.17±6.63。海洛因依赖者渴求、焦虑和抑郁评分与纹状体、尾状核和壳核放射性摄取比值均无显著性差异(P0.05)。 [结论]实验结果说明长期海洛因滥用会导致纹状体内多巴胺转运体的下降。这个结果表明长期的海洛因成瘾可能会损伤到脑的纹状体多巴胺能神经元。第二部分冰毒成瘾者脑多巴胺转运体99mTc-TRODAT-1SPECT显像研究 [目的]应用99mTc-TRODAT-1SPECT显像技术,比较冰毒依赖者与正常志愿者纹状体内多巴胺转运体的改变 [方法]招募21名健康志愿者(男14名,女7名)和25名冰毒依赖者(男17名,女8名)。冰毒依赖者生理性脱毒两周后进行心理渴求评分、汉密顿焦虑量表评分和汉密顿抑郁量表评分。所有受试者均为右利手,两组受试者年龄、BMI均无显著性差异。对健康志愿者和脱毒两周冰毒依赖者进行99mTc-TRODAT-1脑SPECT显像。对SPECT图像进行三维重建,参照正常人MRI图像相应横断面,在SPECT图像上对左侧纹状体、右侧纹状体、左侧尾状核、右侧尾状核、左侧壳核和右侧壳核进行ROI勾画,选取枕叶(OC)作为本底。放射性摄取比值(SURs)=(ROI-OC)/OC。采用SPSS15.0软件,进行统计分析。 [结果]冰毒依赖者双侧纹状体、尾状核和壳核放射性摄取比值明显低于正常对照组(左侧纹状体：1.24±0.31和1.97±0.41,t=6.80,P0.001；右侧纹状体：1.23±0.33和1.99±0.39,t=7.02,P〈0.001；左侧尾状核：1.26±0.33和2.01±0.42,t=6.84,P0.001：右侧尾状核：1.25±0.35和2.05±0.41,t=7.10,P0.001：左侧壳核：1.22±0.31和1.91±0.40,t=6.62,P0.001；右侧壳核：1.22±0.32和1.93±0.38,t=6.94,P0.001)。冰毒依赖者生理性脱毒两周后渴求、焦虑和抑郁评分平均值分别为：3.96±1.97,21.36±10.56和15.92±8.24。冰毒依赖者渴求评分与右侧纹状体、右侧尾状核和右侧壳核存在负相关(r分别为-0.40,-0.39和-0.41)。 [结论]长期冰毒滥用会导致纹状体内多巴胺转运体的下降。稽延期状渴求程度可能与脑内多巴胺转运体的下降有关。第三部分海洛因及冰毒依赖者脑多巴胺转运体改变的研究 [目的]应用99mTc-TRODAT-1SPECT显像技术,比较海洛因依赖者与冰毒依赖者纹状体内多巴胺转运体的改变,同时比较两组稽延期戒断渴求、焦虑和抑郁的程度及关系 [方法]招募21名健康志愿者(男14名,女7名),23名海洛因依赖者(男18名,女5名)及25名冰毒依赖者(男17名,女8名)。海洛因和冰毒依赖者生理性脱毒两周后进行心理渴求评分、汉密顿焦虑量表评分和汉密顿抑郁量表评分。所有受试者均为右利手,三组受试者年龄、BMI均无显著性差异。海洛因组和冰毒组吸毒时间、每天平均毒品用量均没有显著性差异。对健康志愿者、海洛因和冰毒依赖者脱毒两周后进行99mTc-TRODAT-1脑SPECT显像。对SPECT图像进行三维重建,参照正常人MRI图像相应横断面,在SPECT图像上对左侧纹状体、右侧纹状体、左侧尾状核、右侧尾状核、左侧壳核和右侧壳核进行ROI勾画,选取枕叶(OC)作为本底。放射性摄取比值(SURs)=(ROI-OC)/OC。采用SPSS15.0软件,进行统计分析。 [结果]正常对照组、海洛因组和冰毒组双侧纹状体、尾状核和壳核放射性摄取比值均存在显著性差异(左侧纹状体：1.97±0.41,1.33±0.17和1.24±0.31,F=35.79,P0.05：右侧纹状体：1.99±0.39,1.28±0.19和1.23±0.33,F=40.13,P0.05：左侧尾状核：2.01±0.42,1.32±0.16和1.26±0.33,F=38.11,P0.05：右侧尾状核：2.05±0.41,1.27±0.19和1.25±0.35,F=42.07,P0.05；左侧壳核：1.91±0.40,1.33±0.18和1.22±0.31,F=32.38,P0.05：右侧壳核：1.93±0.38,1.28±0.19和1.22±0.32,F=37.12,P0.05)。相同滥用时间剂量情况下,海洛因依赖者与冰毒依赖者比较,双侧纹状体、尾状核和壳核放射性摄取比值没有显著性差异(左侧纹状体：P=0.32；右侧纹状体：P=0.64；左侧尾状核：P=-0.53；右侧尾状核：P=-0.82；左侧壳核：P=-0.21；右侧壳核：P=-0.52)。海洛因依赖者和冰毒依赖者渴求评分存在显著性差异(t=-4.29,P0.05)；海洛因依赖者的汉密顿焦虑量表评分显著低于冰毒依赖者(t=-2.27,P0.05)：海洛因依赖者和冰毒依赖者的汉密顿抑郁量表评分没有显著性差异(t=-1.27,P0.05)。 [结论]长期海洛因和冰毒滥用会导致脑内多巴胺转运体的下降。在吸毒时间和每日平均剂量没有显著性差异的情况下,两种毒品引起的纹状体多巴胺转运体的降低,并不存在显著性差异。冰毒依赖者稽延期渴求、焦虑症状较海洛因依赖者更明显。
[Abstract]:Part one
Dopamine transporter 991Tc-TRODAT-lSPECT imaging in heroin addicts
[Objective] to compare the level of dopamine transporter in striatum of heroin addicts and normal volunteers by 99mTc-TRODAT-1SPECT imaging.
[Methods] 21 healthy volunteers (14 men, 7 women) and 23 heroin addicts (18 men and 5 women) were recruited by heroin addicts for two weeks of physical detoxification, the Hamilton Anxiety Scale (HAMA) score and the Hamilton Depression Scale (HDMA) score. All the subjects were right hand, and the age of two groups, BMI were not obvious. 99mTc-TRODAT-1 brain SPECT imaging was performed on healthy volunteers and heroin addicts for two weeks of detoxification. Three-dimensional reconstruction of SPECT images and corresponding cross sections of normal human MRI images were performed on the left striatum, right striatum, left caudate nucleus, right caudate nucleus, left putamen and right putamen on SPECT images. The occipital lobe (OC) was selected as the background. The Specific uptake ratios (SURs) = (ROI-OC) /OC. was calculated by SPSS15.0 software and analyzed statistically.
[results] the ratio of radioactivity in the bilateral striatum, caudate nucleus and putamen was significantly lower than that of the normal control group (1.33 + 0.17 and 1.97 + 0.41, t=6.63, P0.001; right striatum: 1.28 + 0.19 and 1.99 + 0.39, t=7.55, P (0.001: 1.32 + 0.16 and 2.01 + 0.42, t=7.13, P (0.001: right caudate) Nucleus: 1.27 + 0.19 and 2.05 + 0.41, t=7.87, P (0.001: left putamen: 1.33 + 0.18 and 1.91 + 0.40, t=6.10, P0.001: 1.28 + 0.19 and 1.93 + 0.38, t=7.14, P0.001). The heroin dependent craving after physiological detoxification, the average of anxiety and depression scores were: 1.66,15.39 + 6.63. and 6.63. heroin dependence There was no significant difference in the craving, anxiety and depression scores between the striatum, the caudate nucleus and putamen radiation-uptake ratio (P0.05).
[Conclusion] the results suggest that long term heroin abuse leads to a decrease in dopamine transporter in the striate. This result suggests that long term heroin addiction may damage the striatum dopaminergic neurons in the brain.
The second part
Brain dopamine transporter 99mTc-TRODAT-1SPECT imaging in methamphetamine addicts
[Objective] to compare the changes of dopamine transporters in striatum of methamphetamine dependent volunteers and normal volunteers by 99mTc-TRODAT-1SPECT imaging.
[Methods] 21 healthy volunteers (14 men, 7 women) and 25 ice addicts (17 men and 8 women) were recruited. The psychosocial craving score, Hamilton Anxiety Scale score and Hamilton Depression Scale score were performed for two weeks after physiological detoxification of ice addicts. All subjects were right hand, and there was no significant difference in BMI between the two groups. 99mTc-TRODAT-1 brain SPECT imaging was performed in healthy volunteers and detoxified two weeks of ice addicts. Three-dimensional reconstruction of SPECT images and corresponding cross section of normal human MRI images were performed on the left striatum, right striatum, left caudate nucleus, right caudate nucleus, left putamen and right putamen in ROI to select the occipital lobe (OC) on SPECT images. Background. Radiation-uptake ratio (SURs) = (ROI-OC) /OC. was analyzed by SPSS15.0 software.
[results] the ratio of radioactivity in the bilateral striatum, caudate nucleus and putamen was significantly lower than that of the normal control group (1.24 + 0.31 and 1.97 + 0.41, t=6.80, P0.001; right striatum: 1.23 + 0.33 and 1.99 + 0.39, t=7.02, P < 0.001; 1.26 + 0.33 and 2.01 + 0.42, t=6.84, P0.001: right caudate nucleus. 1.25 + 0.35 and 2.05 + 0.41, t=7.10, P0.001: left putamen: 1.22 + 0.31 and 1.91 + 0.40, t=6.62, P0.001; right putamen: 1.22 + 0.32 and 1.93 + 0.38, t=6.94, P0.001). The score was negatively correlated with the right striatum, right caudate nucleus and right putamen (r = -0.40, -0.39 and -0.41).
[Conclusion] long-term abuse of ice can lead to a decrease in dopamine transporters in striatum. The extent of delayed phase craving may be related to the decrease of dopamine transporters in the brain.
The third part
Changes of dopamine transporter in heroin and methamphetamine addicts
[Objective] to compare the changes of dopamine transporter in heroin addicts and ice addicts in the striatum by 99mTc-TRODAT-1SPECT imaging, and compare the degree and relationship between the two groups of postponement abstinence craving, anxiety and depression.
[Methods] 21 healthy volunteers (14 men, 7 women), 23 heroin addicts (18 men, 5 women) and 25 ice addicts (17 men and 8 women) were recruited, and heroin and ice addicts were physically detoxified for two weeks after two weeks of psychological craving score, Hamilton Anxiety Scale score and Hamilton Depression scale. All the subjects were right-handed. There was no significant difference in the age of the three groups of subjects. There was no significant difference in the average dose of drugs between the heroin group and the ice group. The 99mTc-TRODAT-1 brain SPECT imaging was performed on the heroin and ice addicts after two weeks of detoxification. The three-dimensional reconstruction of the SPECT images was carried out with reference to the corresponding horizontal MRI image of the normal people. On the SPECT image, the left striatum, right striatum, left caudate nucleus, right caudate nucleus, left putamen and right putamen were examined by ROI to select the occipital lobe (OC) as the base. The radioactivity uptake ratio (SURs) = (ROI-OC) /OC. was analyzed by SPSS15.0 software.
[results] there were significant differences in the radioactivity ratio of bilateral striatum, caudate nucleus and putamen in both heroin group and ice group (1.97 + 0.41,1.33 + 0.17 and 1.24 + 0.31, F=35.79, P0.05: right striatum: 1.99 + 0.39,1.28 + 0.19 and 1.23 + 0.33, F=40.13, P0.05: 2.01 + 0.42,1.32 in left caudate nucleus. 0.16 and 1.26 + 0.33, F=38.11, P0.05: right caudate nucleus: 2.05 + 0.41,1.27 + 0.19 and 1.25 + 0.35, F=42.07, P0.05; left putamen: 1.91 + 0.40,1.33 + 0.18 and 1.22 +, F=32.38, P0.05: the right putamen: 1.93 + 0.38,1.28 + 0.19 and 1.22 + 1.25, F=37.12, P0.05). Heroin addicts and methamphetamine There was no significant difference in the ratio of radioactive uptake in the bilateral striatum, caudate nucleus and putamen (P=0.32; right striatum: P=0.64; left caudate nucleus: P=-0.53; right caudate nucleus: P=-0.82; left putamen: P=-0.21; right putamen: P= -0.52). Heroin addicts and ice addicts craving There were significant differences (t=-4.29, P0.05); the Hamilton Anxiety Scale of heroin addicts was significantly lower than that of ice addicts (t=-2.27, P0.05). There was no significant difference in the Hamilton Depression Scale between heroin addicts and ice addicts (t=-1.27, P0.05).
[Conclusion] long term heroin and methamphetamine abuse may lead to the decrease of dopamine transporter in the brain. There is no significant difference in the decrease of the striatum dopamine transporter caused by two drugs in the case of drug taking time and daily average dose. It is more obvious.

【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.64;R817.4

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