阿片依赖者在戒断反应期与脱毒治疗后的细胞免疫功能

CELL MEDIATED IMMUNOFUNCTION OF CHRONIC OPIOID DEPENDENT PERSONS DURIGN WITHDRAWAL AND DETOXIFICATION PERIOD

目的··:探讨阿片依赖者在戒断反应期易发生猝死的机理。方法··:采用免疫组化、细胞培养、核素掺入、ELISA等方法 ,研究比较26例用药模式相近的阿片依赖者在戒断反应期与脱毒治疗后的细胞免疫功能 ,并与健康对照组进行统计分析。结果··:慢性阿片依赖者在戒断反应期CD4+数目减少 ,CD4 +/CD8 +比例降低 ,PBMC合成DNA的能力下降 ,产生IL -2的水平降低 ,血清中免疫抑制性因子sIL -2R水平显著升高 ;上述免疫参数与健康对照组比较差异显著。经脱毒治疗 ,在躯体戒断症状消失后 ,免疫功能提高 ,各项免疫参数前后配对比较差异明显 ,但仍低于正常水平。结论·· :阿片依赖损害人体免疫功能 ,特别是在戒断反应期损害程度严重 ,继而引起机体对外界环境刺激的应激反应降低 。

Objective:To probe into the mechanism of sudden unexpected death occurring frequently in chronic opioid dependent persons during withdrawal period. Method:Immunohistochemistry (APAAP method),cell culture,3H-TdR and ELISA techniques were used to study cell mediated immunofunction of 26 persons with chronic opioid dependence during withdrawal and detoxification period,and compared statistically with that of normal control group. Result: During withdrawal period, the number of T lymphocyte subpopulation CD4+ cells,proportion of CD4+and CD8+,PBMC proliferation ability stimulated by PHA and IL-2 production of PBMC of chronic opioid dependent persons all decreased;while the level of sIL-2R which is an immunosuppressive factor in serum increased.After withdrawal syndrome disappeared, immunofunction was enhanced, but still lower than that of norml control group. Conclusion: Opioid abuse damages human immunofunction and the damage is more serious during withdrawal period. Such immunosuppression reduces body's stress reaction to circumstance stimulation and injury, which results in sudden death.