Levin J M, Holman B L, Mendelson J H, Teoh S K, Garada B, Johnson K A, Springer S
Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115.
J Nucl Med. 1994 Dec;35(12):1902-9.
Cocaine abuse continues to be a major public health concern, with a variety of medical and neurologic sequelae. Previous studies have demonstrated abnormalities in cerebral perfusion in chronic cocaine abusers and after acute administration of cocaine. Although women are becoming increasingly represented among drug abusers, few studies have included women. To the authors' knowledge, none has compared cerebral perfusion in asymptomatic women with that in men.
The cerebral perfusion of 13 cocaine-dependent women, 4 of whom were also heroin dependent, was studied with 99mTc hexamethylpropyleneamine oxime (HMPAO) SPECT. These women were compared with 13 cocaine-dependent men and 26 healthy control subjects. Structural brain lesions and neurologic abnormalities were excluded by MRI and neurologic evaluation. Perfusion studies were interpreted in a standardized fashion by reviewers blinded to clinical information.
It was found that cocaine-dependent women were much less likely to have abnormal study findings than cocaine-dependent men (p = 0.003) and were indistinguishable from normal women (p = 1.0). However, the results in both women and men who concurrently used heroin plus cocaine were all abnormal. Perfusion abnormalities tended to be located in anterior brain structures, such as the frontal and temporal cortex and the basal ganglia.
These data suggest that cocaine-dependent women have fewer abnormalities in cerebral perfusion than cocaine-dependent men, but that concurrent abuse of heroin and cocaine is associated with more perfusion abnormalities in both sexes.
可卡因滥用仍然是一个主要的公共卫生问题，会导致各种医学和神经学后遗症。先前的研究已证明，慢性可卡因滥用者以及急性服用可卡因后会出现脑灌注异常。尽管女性在药物滥用者中的比例越来越高，但很少有研究纳入女性。据作者所知，尚无研究比较无症状女性和男性的脑灌注情况。
对13名可卡因依赖女性（其中4名同时依赖海洛因）进行了99mTc六甲基丙烯胺肟（HMPAO）单光子发射计算机断层扫描（SPECT）研究其脑灌注情况。将这些女性与13名可卡因依赖男性和26名健康对照者进行比较。通过磁共振成像（MRI）和神经学评估排除脑结构病变和神经学异常。由对临床信息不知情的审阅者以标准化方式解读灌注研究结果。
发现可卡因依赖女性出现异常研究结果的可能性远低于可卡因依赖男性（p = 0.003），且与正常女性无差异（p = 1.0）。然而，同时使用海洛因和可卡因的女性和男性的结果均为异常。灌注异常往往位于前脑结构，如额叶和颞叶皮质以及基底神经节。
这些数据表明，可卡因依赖女性的脑灌注异常比可卡因依赖男性少，但同时滥用海洛因和可卡因与两性更多的灌注异常有关。
