网络成瘾者血液中单胺类神经递质水平与治疗转归的相关性

Relationship of treatment outcome with monoamine neurotransmitter content in peripheral blood in patients with internet addiction disorder

目的 比较网络成瘾（IAD）者外周血中单胺类神经递质5-羟色胺（5-HT）、多巴胺（DA）、去甲肾上腺素（NE）浓度水平在治疗前后动态变化,分析其与治疗效果的相关性.方法 对治疗前后的35例网络成瘾者（研究组,IAD组）以及性别、年龄、受教育年限与之相匹配的35例健康志愿者（对照组）均采用高效液相色谱法（HPLC）检测外周血小板5-HT浓度,用酶联免疫吸附法（ELISA）检测血浆DA和NE浓度.用中文网络成瘾量表（CIAS）、家庭功能评定量表（FAD）、HAMD量表、HAMA量表评定两组网络成瘾严重程度和IAD组治疗效果.比较IAD组治疗前后5-HT、DA、NE浓度并与对照组比较,分析其与治疗效果（量表）的相关性.结果 （1）IAD组（治疗前）5-HT（427.82±136.28） ng/L,低于对照组的（522.63±123.25） ng/L（t=3.052,P＜0.05）,DA（65.29±32.52） ng/L,高于对照组的（35.76±22.34） ng/L（t=4.427,P＜0.05）,NE（493.24±137.65） ng/L,高于对照组的（415.28±118.34） ng/L（t=2.540,P＜0.05）.（2） IAD组（治疗后）5-HT（518.35±115.68） ng/L,高于IAD组的（治疗前）（427.82±136.28） ng/L（t=2.996,P＜0.05）,DA（36.45±29.47） ng/L,低于IAD组的（治疗前）（65.29±32.52） ng/L（t=3.887,P＜0.05）,NE （421.75±129.76） ng/L,低于IAD组的（治疗前）（493.24±137.65）（t=2.235,P＜0.05）.但IAD组（治疗后）与对照组比较,5-HT、DA和NE浓度差异均无统计学意义（均P＞0.05）.（3）5-HT浓度与量表评分（CIAS、FAD、HAMa＋d）负相关（r=-0.653、-0.547、-0.409,均P＜0.05）,DA浓度与量表评分正相关（r=0.406、0.375、0.423,均P＜0.05）,NE浓度与量表评分正相关（r=0.505、0.338、0.545,均P＜0.05）.结论 网络成瘾者外周血中单胺类神经递质浓度可能与疗效相关;5-HT浓度与疗效正相关,DA、NE与疗效负相关.

Objective To investigate the changes of the concentrations of monoamine neurotransmitter serotonin （5-HT）,dopamine （DA）,norepinephrine （NE） in peripheral blood in patients with intemet addiction disorder （IAD） between before and after the treatment,and to analyze the correlation with treatment effect.Methods 35 cases with IAD （IAD group） before and after treatment and 3 5 healthy volunteers matched with sex,age and education （control group） were detected the concentration of 5-HT in peripheral platelets by high performance liquid chromatography （HPLC）,and DA and NE in plasma by enzyme-linked immuno-sorbent assay （ELISA）,respectively.The Chinese Internet Addiction Scale （CIAS）,Family Assessment Device （FAD）,HAMD,HAMA were used to determine the internet addiction severity of two groups and the curative efficacy of IAD group.To compare the concentrations of 5-HT,DA,NE between before and after treatment in IAD group,and compared with the control group,and the correlation analysis was performed between it and the treatment effect （scale）.Results （1） Before treatment,the concentration of 5-HT in IAD group （427.82 ± 136.28） ng/L was significantly lower than in the control group （522.63 ± 123.25） ng/L （t =3.052,P 〈 0.05）,while DA （65.29 ± 32.52） ng/L was significantly higher than the control group （35.76 ± 22.34） ng/L （t =4.427,P 〈 0.05）,NE （493.24 ± 137.65） ng/L was signific.antly higher than control group （415.28 ± 118.34） ng/L （t =2.540,P 〈 0.05）.（2） In IAD group,the concentration of 5-HT after treatment （518.35 ± 115.68） ng/L was significantly higher than before treatment （427.82 ± 136.28） ng/L （t =2.996,P 〈 0.05）,while DA （36.45 ± 29.47）ng/L was significantly lower than before treatment （65.29 ± 32.52） ng/L （t =3.887,P 〈 0.05）,NE （421.75 ± 129.76） ng/L was significantly lower than before treatment （493.24 ± 137.65） ng/L （t =2.235,P 〈 0.05）.But compared the IAD group after treatment with the control group,the concentrations of 5-HT,DA and NE showed no significant differences （all P 〉 0.05）.（3） The negative correlation was found between the concentration of 5-HT and the scores of scales （CIAS,FAD,HAMa ＋ d） （r =-0.653,-0.547,-0.409,all P 〈 0.05）,while DA had significantly positive.correlation with the scores （r =0.406,0.375,0.423,all P 〈 0.05）,NE was positively correlated with the scores （r =0.505,0.338,0.545,all P 〈 0.05）.Conclusion The concentrations of monoamine neurotransmitters in the peripheral blood in patients with IAD may be related to the efficacy.The concentration of 5-HT had positive correlation with the efficacy,DA,NE had negative correlation with it.