Lieb B, Bonnet U, Specka M, Augener S, Bachmann H S, Siffert W, Scherbaum N
Addiction Research Group at Department of Psychiatry and Psychotherapy, LVR-Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany.
Prog Neuropsychopharmacol Biol Psychiatry. 2009 Jun 15;33(4):663-7. doi: 10.1016/j.pnpbp.2009.03.008. Epub 2009 Mar 19.
The intensity of withdrawal in opiate dependence shows a high inter-individual variability. The 825C>T polymorphism (rs5443) of the G-protein beta 3 (GNB3) subunit gene has a strong influence on clinical signs of sympathetic activity in cardiac research. This study was carried out in order to test the hypothesis that carriers of the T allele have an increased sympathetic activity in opiate withdrawal.
Thirty-nine monovalent opiate addicted patients consecutively admitted to a detoxification ward were investigated. The main parameter for sympathetic activity was the pulse rate in the first 3 days after the regular end of gradual methadone reduction.
Thirty-three out of 39 patients achieved a drug-free state: 22 carried a T allele (TT, CT), 11 belonged to the CC genotype group. The pulse rate was significantly (p<0.05) raised in the T allele group compared to the CC genotype group on the first 2 days after stopping methadone administration. In addition, about a third of the T allele carriers needed clonidine treatment on the respective days, but only one patient among the 11 CC homozygotes. There was no significant difference between groups in systolic and diastolic blood pressures as well as in subjective withdrawal ratings.
A group difference regarding pulse rate could be observed in a small sample and despite a higher degree of concomitant clonidine medication in T allele carriers. The failure to detect group differences in blood pressure and self-rated withdrawal symptoms may be attributed to the more complex regulation of blood pressure and the known weak correlation between objective and subjective withdrawal symptoms.
阿片类药物依赖戒断的强度存在高度个体差异。G蛋白β3(GNB3)亚基基因的825C>T多态性(rs5443)对心脏研究中交感神经活动的临床体征有强烈影响。本研究旨在检验T等位基因携带者在阿片类药物戒断时交感神经活动增加这一假设。
对连续入住戒毒病房的39名单价阿片类药物成瘾患者进行调查。交感神经活动的主要参数是美沙酮逐渐减量正常结束后前3天的脉搏率。
39名患者中有33名达到了无药状态:22名携带T等位基因(TT、CT),11名属于CC基因型组。在停用美沙酮后的头2天,T等位基因组的脉搏率显著高于CC基因型组(p<0.05)。此外,约三分之一的T等位基因携带者在相应日子需要可乐定治疗,但11名CC纯合子中只有1名患者需要。两组在收缩压和舒张压以及主观戒断评分方面没有显著差异。
在一个小样本中,尽管T等位基因携带者同时使用可乐定的程度较高,但仍观察到脉搏率存在组间差异。未能检测到血压和自评戒断症状的组间差异可能归因于血压调节更为复杂,以及客观和主观戒断症状之间已知的弱相关性。