Substance abuse and cerebral blood flow.
Substance abuse and cerebral blood flow.
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DOI：
10.1176/ajp.148.3.292
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发表时间：
1991-03
期刊：
影响因子：
--
通讯作者：
R. Mathew;W. Wilson
中科院分区：
文献类型：
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作者：
R. Mathew;W. Wilson
目的与方法本文综述了药物滥用对脑血流和代谢的急性和慢性影响及其临床意义。该综述最重要的信息来源是发表在参考期刊上的人类研究报告。一些动物研究，书籍章节和摘要，特别是相关的也包括在内。结果在人类中，小剂量的乙醇会引起脑血管扩张;较高剂量会引起脑血管收缩。慢性酒精中毒与CBF和脑代谢减少有关。镇静剂和抗焦虑药物导致CBF和脑代谢全面降低。咖啡因，即使是小剂量，也是一种有效的脑血管收缩剂。吸烟后立即观察到脑血管舒张，但慢性吸烟者显示CBF总体减少。吸食大麻后CBF的变化是可变的;增加和减少都可以看到。然而，长期吸食大麻似乎会减少CBF。大多数鼻吸剂和溶剂是血管扩张剂;慢性滥用伴随着CBF的减少。一些滥用药物，包括乙醇、安非他明、可卡因、尼古丁和咖啡因-苯丙醇胺组合，增加中风的风险。与长期使用乙醇、尼古丁、吸入剂和溶剂相关的CBF减少在戒烟后至少部分可逆。未来研究的主题包括区域脑功能，介导药物引起的情绪变化（欣快症）; CBF伴随的心理和生理特征，增加成瘾潜力; CBF的变化，伴随戒断综合征;机制负责药物引起的中风;和功能和器质性并发症对CBF的影响。
OBJECTIVE AND METHOD This paper reviews acute and chronic effects of drugs of abuse on cerebral blood flow (CBF) and metabolism and their clinical significance. The most important source of information for the review is human research reports published in refereed journals. A few animal studies, book chapters, and abstracts that are especially relevant are also included. RESULTS In humans, ethanol in small doses produces cerebral vasodilation; higher doses induce cerebral vasoconstriction. Chronic alcoholism is associated with reduced CBF and cerebral metabolism. Sedatives and antianxiety drugs lead to global reduction in CBF and cerebral metabolism. Caffeine, even in small doses, is a potent cerebral vasoconstrictor. Cerebral vasodilation is seen immediately after cigarette smoking, but chronic smokers show global reduction in CBF. Changes in CBF after marijuana smoking are variable; both increases and decreases are seen. Chronic marijuana smoking, however, seems to reduce CBF. Most inhalants and solvents are vasodilators; chronic abuse is accompanied by a decrease in CBF. A number of drugs of abuse, including ethanol, amphetamines, cocaine, nicotine, and caffeine-phenylpropanolamine combinations, increase the risk for stroke. Reduction in CBF associated with chronic use of ethanol, nicotine, inhalants, and solvents is at least partially reversible upon abstinence. CONCLUSIONS Topics for future research include regional brain function, which mediates drug-induced mood changes (euphoria); CBF concomitants of psychological and physiological characteristics that increase addiction potential; changes in CBF that accompany withdrawal syndromes; mechanisms responsible for drug-induced stroke; and effects of functional and organic complications on CBF.