药物依赖综合征患者血浆蛋白标志物分析:观察性临床研究

I. Bykov, D. Lubchenko, K. Popov, A. N. Stolyarova, M. Popova, O. Tsymbalov, E. E. Esaulenko
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引用次数: 0

摘要

背景。在药物成瘾治疗中,诊断过程是基于中毒底物或其代谢物的化学毒理学测定。可构成二级预防基础的实验室监测和预测问题仍未得到解决。特异性神经组织蛋白被认为是最有前途的药物病理学实验室标志物。目的:探讨药物依赖综合征患者血浆中蛋白质化学性质的潜在生物标志物。该研究是根据2021年7月至2022年7月在克拉斯诺达尔边疆区麻醉科药房进行的一项观察性临床试验的设计进行的。主组(第二组)包括31例诊断为物质依赖综合征的患者。对照组(组1,n = 15)由健康体检者组成。在解毒稳定治疗和康复期间,血浆中检测了5种蛋白:脑和胶质源性神经营养因子、神经元特异性烯醇化酶、α -突触核蛋白和钙结合蛋白S100B。数据的统计分析采用Mann-Whitney检验比较对照组和实验组的数值,采用Wilcoxon检验比较同一组在不同观察阶段的数值。使用StatPlus version 7 (AnalystSoft Inc., USA)进行计算。主组共纳入31例患者,其中18例随访诊断为阿片类药物依赖综合征(n = 11)或精神兴奋剂依赖综合征(n = 7)。患者因拒绝参与研究或接受康复治疗,或因疾病复发退出研究。入院时,患者血浆中脑源性神经营养因子下降45% (p < 0.001),康复疗程后下降3.9倍(p < 0.001)。入院时血浆胶质源性神经营养因子高于对照组1.9倍(p < 0.001),但入院后迅速恢复正常。血浆神经元特异性烯醇化酶水平也较差,比对照组低36% (p <0.001),但在康复结束时接近对照组。该研究获得了阿片类药物或精神兴奋剂依赖患者血浆中神经营养因子变化的数据。康复期神经营养因子水平提高较快;然而,尽管治疗成功,脑源性神经营养因子仍然减少,这可能表明不可逆的变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of Protein Markers in Plasma of Patients with Drug Dependence Syndrome: Observational Clinical Study
Background. In drug addiction treatment, the diagnostic process is based on the chemical toxicological determination of the intoxication substrate or its metabolite. Laboratory monitoring and prediction issues that could form the basis of secondary prevention remain unresolved. Specific nervous tissue proteins are considered to be the most promising laboratory markers of drug pathology.Objective — to determine some potential biomarkers of protein-chemical nature in the plasma of patients with drug dependence syndrome.Methods. The study was conducted according to the design of an observational clinical trial at the Narcological Dispensary of Krasnodar Krai in the period from 07.2021 to 07.2022. The main group (group 2) included 31 patients diagnosed with substance dependence syndrome. The control group (group 1, n = 15) consisted of healthy subjects submitted to occupational medical examinations. During the detoxification-stabilization therapy and rehabilitation, 5 proteins were determined in the plasma: brainand glial-derived neurotrophic factors, neuron-specific enolase, alpha-synuclein and calcium-binding protein S100B. Statistical analysis of the data involved the Mann-Whitney test for comparing the values of the control and experimental groups and the Wilcoxon test for comparing the values of one group obtained at different stages of observation. The calculations were carried out using StatPlus version 7 (AnalystSoft Inc., USA).Results. A total of 31 patients were included in the main group, 18 of them were followed up with a diagnosis of opioid dependence syndrome (n = 11) or psychostimulant dependence syndrome (n = 7). Patients dropped out of the study due to their refusal to participate in the study or undergo rehabilitation, or due to relapse of the disease. When admitted to the hospital, patients indicated a 45% decrease in brain-derived neurotrophic factor in the plasma ( p < 0.001), and a 3.9-fold decrease after rehabilitation course ( p < 0.001). Glial-derived neurotrophic factor in the plasma exceeded the controls 1.9 times ( p < 0.001) upon admission to hospital, but rapidly returned to normal values thereafter. Level of neuron-specific enolase in the plasma was also poor, 36% lower than the controls ( p <0.001), but approached the control values by the end of rehabilitation.Conclusion. The study obtained data indicating the changes in neurotrophic factors in the blood plasma of patients with opioid or psychostimulant dependence. The rehabilitation period was marked by a relatively rapid improving level of neurotrophins; however, brain-derived neurotrophic factor remained reduced despite the successful treatment, which may indicate the irreversible changes.
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