男性酒依赖患者决策倾向的对照研究

Controlled trial of decision-making tendency in male alcohol dependent patients

目的:探讨酒依赖男性患者的决策倾向以及与戒酒后复饮相关性。方法:将35例酒依赖患者及与其相匹配的44名健康者(正常对照组)作为研究对象,采用爱荷华博弈任务(Iowa gambling task,IGT)进行风险决策行为能力的测试,并对持续戒酒时间进行电话随访。结果:酒依赖组在IGT中净不利选牌数(5.14±21.57)明显高于正常对照组(-8.05±13.07),差异有统计学意义(t=3.357,P=0.001)。2(组)×5(阶段)方差分析结果显示,在净不利选牌数上组间主效应显著[F=12.338,P=0.001];阶段主效应亦显著[F=17.824,P<0.001]。相对于正常对照组,酒依赖组在IGT第3、4、5阶段净不利选牌数较多(F=5.661,P=0.020;F=9.252,P=0.003;F=9.980,P=0.002)。酒依赖患者持续戒酒时间与决策第5阶段净不利选择数呈负相关(r=-0.417,P=0.013)。结论:男性酒依赖患者存在决策功能异常,戒酒后复饮与决策功能有一定相关性。

Objective： To explore the correlation between decision-making tendency and recurrence of male patients with alcohol dependence （AD）. nethod：A total of 35 male AD patients were compared with matched 44 health controls （HC）. Decision-making function of all the subjects were assessed by Iowa Gambling Task（IGT） ,The duration of their abstinence was followed up by telephone. Results：The number of the net disadvantageous cards in AD group was more than that in HC group [ （5.14 ±21.57）, （ -8.05 ± 13.07） ,respectively] ,the difference between them was statistically significant （ t = 3. 357, P = 0. 001 ）. 2 （group） × 5 （block） ANOVA results revealed a significant main effect of group and block on the scores of net advantageous from the 1GT （ F = 12. 338, P = 0. 001 ; F = 17. 824, P 〈 0.001 ）. Compared with HC group, AD group showed significantly more net disadvantageous cards in block 3,4,5 of 1GT （ F = 5. 661, P = 0. 020 ; F = 9. 252, P = 0. 003 ;F = 9. 980 ,P = 0.002 respectively）. The time of abstinence in AD patients had negative correlation to the number of the net disadvantageous cards in the fifth block （ r = - 0. 417, P = 0. 013 ）. Conclusion： The present study suggests that there should be decision-making impairment in male AD patients, which may be associated with the recurrence of alcohol drinking after abstinence treatment.