| 摘要: | 本實驗招募89位從美沙冬門診、監獄或是藥物戒治所中之海洛因成癮患者，其中受試者有重大內科或神經科疾病患者、HIV、智能障礙或因身體有其他障礙而無法配合者，以上予以排除在本實驗外。研究目的為：美沙冬替代療法（methadone maintenance treatment, MMT）對於罹患C型肝炎藥物濫用者的憂鬱程度之影響、脂肪酸代謝與其相關基因多型性之探討。將89位藥物成癮者分為有無C肝兩組，評估及統計分析受試者之基本資料、生化數值（SGOT、SGPT、r-GT）、濫用藥物種類、血液傳染疾病感染率以及各項量表之結果；在使用美沙冬治療前後抽血，分析其紅血球細胞膜脂肪酸；並探討海洛因成癮者脂肪酸代謝之相關基因多型性。實驗結果發現，患有C型肝炎的藥物濫用者在治療前的睡眠品質和生活品質都有較差的趨勢，在使用MMT治療前後脂肪酸的比較，有C肝及無C肝兩組的SFA都有顯著上升，而PUFA及AA/EPA ratio皆顯著下降，其中在MMT治療後，有C肝組的AA/EPA ratio相較於無C肝組的有顯著升高，這可能會導致患有C型肝炎的藥物濫用者憂鬱症狀或罹患其他精神疾病的機率增加。在基因方面，PLA2及PPAR gamma並無變異，而FADS1、FADS2、FADS3之基因多型性雖有變異，但與n6/n3 PUFAs相比皆無統計上的差異。
In this study, we recruited 89 heroin users from methadone clinics, prisons or drug abuser treatment center. People who were had medical problems, neurological diseases, HIV, mental handicap, and other barriers were excluded from the study. The purpose of this study was the effect of methadone maintenance treatment (MMT) for drug abusers also suffering hepatitis C on fatty acid metabolism, the degree of depression and gene polymorphism. The 89 drug abusers were divided into two groups, drug abusers with or without hepatitis C. The patient characteristics, biochemical values (SGOT, SGPT, r-GT), types of drug abuse, prevalence of blood-borne diseases, and scales were analyzed. We analyzed the erythrocyte membrane phospholipid of before and after methadone maintenance treatment. Furthermore, we investigated polymorphisms in genes of fatty acid metabolism in heroin users. The results showed that before MMT, drug abusers also suffering hepatitis C had sleep disturbances and lower quality of life scores than after. The difference of erythrocyte membrane phospholipid between MMT before and after, no matter drug abusers also suffering hepatitis C or not, the SFA was significantly increased, PUFA and AA/EPA ratio were decreased significantly. Further, after MMT, AA/EPA ratio of drug abusers also suffering hepatitis C was higher than drug abusers without hepatitis C significantly. It might result in drug abusers also suffering hepatitis C had high prevalence of psychiatric disorders. On the other hand, there is no difference in the allele frequencies of PLA2 and PPAR gamma polymorphisms. There is difference in the allele frequencies of FADS1, FADS2 and FADS3 polymorphisms, but there is no significant difference with n6/n3 PUFAs. |
