- 學位論文
血液學生物標記於物質使用障礙病患之探討
The Studies of Hematological Biomarkers in Patients with Substance Use Disorder
摘要
中文摘要 毒品使用在全球包括台灣都是難解的重大議題，而「成癮物質使用障礙」是慢性復發性腦部疾病，發展該障礙可運用的生物標記受到廣泛關注。本研究探討物質使用障礙與血液學生物標記之關聯。第一部分研究就958名海洛因使用障礙者分析其血液學的特性及變化、巨紅血球症盛行率，與其相關因素。發現近五分之一的參與者有巨紅血球症，遠高於一般人的盛行率。相關因子包括年齡較大、男性以及前一個月酒精使用天數較多。第二部分研究以甲基安非他命引發精神病症、思覺失調症病人及健康受試者，共計905人的淋巴球相關比率（包括嗜中性球與淋巴球比率NLR、單核球與淋巴球比率MLR及血小板與淋巴球比率PLR），分析三組的差異，發現上述兩個病患組的NLR和MLR均高於健康組，然而三組之間PLR無顯著差異。更發現甲基安非他命引發精神病症的發炎反應近似於思覺失調症病人，卻明顯和健康常人不同，顯示兩組病人在免疫學上潛在相似性。平均紅血球體積(MCV)、NLR及MLR，雖非特異性但便宜易取，分別於海洛因使用障礙者及甲基安非他命引發精神病症者，可作為有參考價值的血液學生物標記。透過本研究得以進一步了解發生在此病患族群的血液學相關的免疫反應與該生物標記臨床應用的可能性，也為未來相關研究提供可用之實證基礎。
並列摘要
英文摘要 Being a significant issue worldwide, including in Taiwan, substance use disorders are chronic and relapsing brain diseases. The development of eligible biomarkers has garnered widespread attention. This study primarily investigated the association between substance use disorders and potential hematological biomarkers. Firstly, of our 958 individuals with heroin use disorder, their hematological characteristics, the prevalence of macrocytosis and its associated factors have been analyzed. Nearly one-fifth of the participants were found to have macrocytosis, which was much higher than that of the general population. Whereas the associated factors included older age, male, and more days of alcohol use in the previous month. We further investigated value differences of lymphocyte-related ratios [namely, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR)] among patients with methamphetamine-induced psychotic disorder or schizophrenia patients, and healthy participants (totally 905 individuals recruited). While both patient groups had higher levels of NLR and MLR versus the healthy group, the similar levels in PLR among the three. The results might suggest that the inflammatory responses of methamphetamine-induced psychosis, at least in part, were quite similar with those of schizophrenia patients, while not found in the healthy individuals. Mean corpuscular volume (MCV) or NLR and MLR might exhibit to be eligible hematological biomarker(s) clinically in patients with heroin use disorders or with methamphetamine use disorders, respectively. Although non-specific, these hematological factors are unquestionably inexpensive and readily available. Our results might offer in substance abusers the additive understanding of hematologic aspects of immune responses and the likelihood of future clinical eligibitity of related biomarkers, as well as the fundamental information for future relevant researches.