目的：了解海洛因依赖人群出现与帕金森病类似的症状体征的情况。

　　方法：采用帕金森病统一评分量表(United Parkinson's Disease Rate Scale，UPDRS量表)对121名海洛因依赖者及31名年龄、性别、文化程度相匹配的对照组志愿者进行评分，其数据作统计学分析。

　　结果：海洛因依赖人群的UPDRS分值显著高于对照组志愿者，静脉吸毒、复吸、长期吸毒均能提高UPDRS分值，对于震颤、动作缓慢、姿势不稳、步态异常等症状，海洛因依赖者的出现率明显高于正常对照组。

　　结论：海洛因依赖可导致类似于帕金森病的症状体征出现，其原因可能是由于脑内黑质纹状体多巴胺系统受损。

　　关键词：海洛因依赖；帕金森病；UPDRS量表

　　参考文献：

　　[1]Apaydin H,Ahlskog JE,Parisi JE,et al.Parkinson's disease neuropathology:later-developing dementia and loss of the levodopa response[J].Arch Neurol,2002,59:102-112

　　[2]Heales S,Crawley F,Rudge P.Reversible parkinsonism following heroin pyrolysate inhalation is associated with tetrahydrobiopterin deficiency[J].Mov Disord,2004,19:1248-1251

　　[3]Domingo P,Martinez E.Parkinsonism associated with long-term cocaine abuse[J].Arch Intern Med,1997,157:241

　　[4]O'Suilleabhain P,Giller C.Rapidly progressive parkinsonism in a self-reported user of ecstasy and other drugs[J].Mov Disord,2003,18:1378-1381

　　[5]Olive JM,Masana L,Gonzalez J.Meperidine and reversible parkinsonism[J].Mov Disord,1994,9:115-116

　　[6]Uitti RJ,Snow BJ,Shinotoh H,et al,Parkinsonism induced by solvent abuse[J].Ann Neurol,1994,35:616-619

　　[7]Carlen PL,Lee MA,Jacob M,et al.Parkinsonism provoked by alcoholism[J].Ann Neuro,1981,l 9:84-86

　　[8]Centers for Disease Control (CDC).Street-drug contaminant causing parkinsonism[J].MMWR Morb Mortal Wkly Rep,1984,33:351-352

　　[9]McKinlay A,Grace RC,Dalrymple-Alford JC,et al.The accuracy of the unified parkinson's disease rating scale (UPDRS-Section 1) as a screening measure for depression[J].Parkinsonism Relat Disord,2007

　　[10]Dhopesh VP,Yagnik PM,Weddington WW.Can cocaine abuse cause parkinsonism[J]? Am J Addict,1997,6:177-179

　　[11]Acquas E,Carboni E,Di Chiara G.Profound depression of mesolimbic dopamine release after morphine withdrawal in dependent rats[J].Eur J Pharmacol,1991,193:133-134

　　[12]Crippens D,Robinson TE.Withdrawal from morphine or amphetamine:different effects on dopamine in the ventral-medial striatum studied with microdialysis[J].Brain Res,1994,650:56-62

　　[13]Rothblat DS,Rubin E,Schneider JS.Effects of chronic alcohol ingestion on the mesostriatal dopamine system in the rat[J].Neurosci Lett,2001,300:63-66

　　[14]Harvey DC,Lac ′an G,Melegan WP.Regional heterogeneity of dopaminergic deficits in vervet monkey striatum and substantia nigra after methamphetamine exposure[J].Exp Brain Res,2000,133:349-358

　　[15]Wilson JM,Kish SJ.The vesicular monoamine transporter,in contrast to the dopamine transporter,is not altered by chronic cocaine self-administration in the rat[J].J Neurosci,1996,16:3507-3510

　　[16]Mash DC,Ouyang Q,Pablo J,et al.Cocaine abusers have an overexpression of alpha-synuclein in dopamine neurons[J].J Neurosci,2003,23:2564-257

　　[17]McCann UD,Wong DF,Yokoi F,et al.Reduced striatal dopamine transporter density in abstinent methamphetamine and methcathinone users:evidence from positron emission tomography studies with[11C]WIN-35,428[J].J Neurosci,1998,18:8417-8422

　　[18]Wolters EC,Van Wijngaarden GK,Stam FC,et al.Leucoencephalopathy after inhaling "heroin" pyrolysate[J].Lancet,1982,2:1233-1237

　　[19]Andersen SN,Skulleru DK.Hypoxic/ischaemic brain damage,especially Pallidal lesions,in heroin addicts[J].Forensic Sci Int,1999,102:51-59

　　[20]曾雪霞,何启亚,符鹏,等.海南省吸毒人群HIV感染状况调查[J].中国艾滋病性病,2007,13:23-25

　　[21]Wang GJ,Chang L,Volkow ND,et al.Decreased brain opaminergictransporters in HIV-associated dementia patients[J].Brain,2004,127:2452-2458

　　[22]周燕,叶峻,韦献良,等.海洛因成瘾复吸大鼠中脑腹侧被盖区、伏隔核神经元超微结构和全脑多巴胺递质含量变化的研究[J].广西医科大学学报,2005,22:185-188