课题背景：本课题组于2005年成功研制出长效纳曲酮缓释剂植入剂型，解决了纳曲酮口服剂型临床依从性差的关键问题。在科技部中国技术市场管理促进中心和湖北省禁毒委办公室的组织下，2006-10/12进行了第二次全国疗效调研。本实验使用事件相关电位客观地评估纳曲酮治疗阿片类药物依赖患者心理渴求的效果。

应用要点：本文从研究方法上采用先进的脑电事件相关电位数据采集技术，避免了阿片类药物依赖者在心理调查中掩饰自己心理渴求而产生的测量误差，也不要求被试对图片刺激作出评价，避免了被试的主观意识的参与，使采集的数据更客观地反应被试的真实情况。从而可以对纳曲酮疗效做出更为客观的评估。

术语解析：长效纳曲酮缓释剂植入剂型，主料是纳曲酮，辅料是聚乳酸，皮下植入3.1 g于腹壁两侧，可缓释长达12个月，纳曲酮血药浓度达到1.57~26.11 μg/L，平均（10.01±5.67）μg/L，可有效阻断外源性阿片类药物500 mg与脑内阿片受体结合，拮抗欣快效应，达到戒除阿片类药物的效果。

摘要
目的: 在前期成功研制出长效纳曲酮缓释剂植入剂型的基础上，应用线索诱发事件相关电位观察长效纳曲酮缓释剂植入治疗阿片依赖者心理渴求的神经心理学作用。
方法：①对象和分组：阿片依赖综合征患者自湖北、湖南和广东等地，包括两个不同戒毒方式的组，即长效纳曲酮缓释剂治疗组和强制戒毒组，同时设计一个未戒毒的阿片依赖对照组和一个健康对照组。②方法：采用事件相关电位记录被试由图片的情绪内涵激发的脑内电活动，无需被试对所观察的图片作出外显反应，现场采集记录其观看药物相关情景线索图片和中性图片时产生的脑电事件相关电位波形。
结果：①长效纳曲酮缓释剂治疗组各波形的潜伏期和波幅已接近健康对照组（P > 0.05）；而强制戒毒组和阿片依赖对照组的P200潜伏期与健康对照组差异非常显著（P < 0.01）；而且，与未治疗的阿片依赖对照组比较，强制戒毒组没有表现出显著的P200正常化的效应。②源定位分布表明，观察药物相关线索图片P200的源发生点健康对照组在中脑导水管周围灰质，长效纳曲酮缓释剂治疗组在扣带回后部，强制戒毒者在内侧前额叶皮质，阿片依赖对照组在大脑前额叶皮质。
结论：①与强制戒毒比较，长效纳曲酮缓释剂植入能降低心理渴求，使患者的心理状况更好。②长效纳曲酮缓释剂治疗能有效改善阿片药物依赖者的神经系统功能，抑制其心理渴求的高级神经活动。
关键词：长效缓释剂；纳曲酮；植入；阿片类药物依赖；线索诱发；事件相关电位

何胜昔，于龙川，王冬梅，胡疏，贾少微.长效纳曲酮缓释剂植入治疗阿片依赖渴求的线索诱发事件相关电位评价[J].中国组织工程研究与临床康复，2008，12(6):1027-1030 [www.zglckf.com/zglckf/ejournal/upfiles/08-6/6k-1027(ps).pdf]

Cue-elicited event-related potential evaluation of long-term sustained release naltrexone treatment for opioid dependence

Abstract

AIM：To explore the neuropsychological mechanisms of long-term sustained release naltrexone (LSRNTX) treatment for opioid dependence response to cue-elicited event-related potential (ERP).
METHODS: ①Patients with opioid dependence syndrome from Hubei province, Hunan province and Guangdong province were divided into three groups: LSRNTX treatment group, forced abstinence group and dependence control group, adding on healthy control subjects.②Without any overt response on each picture, all subjects were recorded for ERP waveform when they saw two blocks of pictures, including drug-relevant and neutral stimuli.
RESULTS: ①The latency and amplify of P200 for cue reactivity in patients treated with LSRNTX did not differ significantly from healthy control subjects (P > 0.05); But dependence control group and forced abstinence group showed an extremely significant worse condition compared with healthy controls (P < 0.01); In comparison with non-treated dependence controls, the forced abstinent subjects led to no significant improvement in P200 normalization.②BESA 5.0 software results showed that sources of P200 response to drug-relevant pictures in healthy control subjects, LSRNTX treatment group, forced abstinence group and dependence control group were located at mid-brain periaqueductal gray, posterior cingulate cortex, medial prefrontal cortex and prefrontal cortex, respectively.
CONCLUSION: ①LSRNTX implants lead to lower craving and significantly better psychological conditions than forced abstinence.②LSRNTX treatment can improve the neurological function of opioid addicts and inhibit their psychological craving.

He SX, Yu LC, Wang DM, Hu S, Jia SW.Cue-elicited event-related potential evaluation of long-term sustained release naltrexone treatment for opioid dependence.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(6):1027-1030(China)
[www.zglckf.com/zglckf/ejournal/upfiles/08-6/6k-1027(ps).pdf]