怀孕吸烟者使用尼古丁贴剂或尼古丁鼻喷剂对体内尼古丁和可替宁浓度的影响
2009/08/11
目的：本试验在怀孕吸烟者中研究使用尼古丁贴剂或尼古丁鼻喷剂对尼古丁暴露指标、戒断症状以及对母亲和胎儿心率的短期影响。
方法：在孕妇吸烟过程中，对孕妇体内的尼古丁/可替宁浓度进行检测，并对孕妇和胎儿心率进行8小时的监测。之后应用尼古丁贴剂（15 mg/16 h）、尼古丁鼻喷剂（推荐方案：每天24次）或安慰剂治疗后4天再次检测上述指标。每日评价尼古丁戒断症状。
结果：21名平均每日吸烟17支的吸烟者完成了上述2次检测。所有组的患者体内尼古丁浓度均较基线值下降（p = 0.002）。可替宁浓度的变化百分比在各组间存在差异（安慰剂组下降77％；鼻喷剂组下降70％；尼古丁贴剂组下降48％；p＝0.029）。与尼古丁贴剂组相比，安慰剂组和尼古丁鼻喷剂组的孕妇心率降低（p=0.021）。在第二次8小时监测过程中，安慰剂组的胎儿基线心率有所下降，但尼古丁贴剂组和鼻喷剂组却有轻度增加。治疗与时间交互作用接近显著（p = 0.052）。与其它两组相比，尼古丁贴剂组每日烟草渴求度下降程度较大（p = 0.025）。
结论：尼古丁贴剂和尼古丁鼻喷剂能降低吸烟孕妇的尼古丁暴露，而且有助于戒烟。
（陈欣 审校）
Oncken C, et al. J Matern Fetal Neonatal Med. 2009 Jun 12:1-8. [Epub ahead of print]
Effects of nicotine patch or nasal spray on nicotine and cotinine concentrations in pregnant smokers.
Oncken C, Campbell W, Chan G, Hatsukami D, Kranzler HR.
Department of Medicine.
Objective. To examine the short-term effects of the nicotine patch or nasal spray on measures of nicotine exposure, withdrawal symptoms, and on maternal and fetal heart rates in pregnant smokers.
Methods. We measured nicotine/cotinine concentrations and maternal and fetal heart rates during an 8-h monitoring session while smoking and again after 4 days of nicotine patch (15 mg/16 h), nasal spray (recommended regimen of 24 doses per day), or placebo treatment. Nicotine withdrawal symptoms were assessed daily.
Results. Twenty-one subjects, who smoked an average of 17 cigarettes per day, completed both monitoring sessions. Nicotine concentrations decreased from baseline smoking concentrations in all groups (p = 0.002). Percent change in cotinine concentration differed across groups (reduction = 77% with placebo, 70% with nasal spray, and 48% with patch; p = 0.029). Maternal heart rate decreased in the placebo and nasal spray groups compared with the patch group (p = 0.021). The baseline fetal heart rate decreased in the placebo group throughout the second monitoring session, but increased slightly in the patch and nasal spray groups. The treatment by time interaction was marginally significant (p = 0.052). Daily, cigarette craving decreased more in the patch versus the other groups (p = 0.025).
Conclusions. Nicotine patch and nasal spray reduce maternal nicotine exposure compared with smoking and may be effective for smoking cessation.
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安非他酮和认知行为治疗对戒烟治疗期正向情感、负向情感及吸烟冲动的影响
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应用伐尼克林戒烟：额外12周应用伐仑克林维持戒烟的成本－效益分析
