Ethanol Patch Test와 음주 후 불편감과의 관계에 대한 연구

Ethanol Patch Test and Aversive Effects to Alcohol

It has been well known that alcoholism is influenced by multiple factors such as biological, social and familial factors. Recently many researches are focusing on further investigation of biological aspects, especially on enzymes of acetaldehyde metabolism. The low Km aldehyde dehydrogenase (ALDH-I) has been implicated to play a major part in the metabolism of acetaldehyde. Therefore ALDH-I deficiency has been assumed to give rise to aversive effects to alcohol which are caused by a high blood acetaldehyde concentration. Recently Ethanol Patch Test (EPT) was suggested as a screening test to dectect ALDH-I deficiency. The mechanism of skin erythema of EPT is presumed to involve vasodilatation due to an accumulation of acetaldehyde in the skin. The lack of ALDH-I in the skin may be responsible for the delayed metabolism of acetaldehyde. This study was designed to evaluate the relationship between time of disappearance of skin erythema in EPT and aversive effects to alcohol in 38 alcoholic patients and 42 control subjects. The results were as follows : 1) The difference of total lenght of times of disappearance of skin erythema in EPT between two groups was significant. 2) When a patch area showed erythema 10 minutes after removal, it was judged to be ALDHI dificiency. 10.52 % of alcoholic patients and 32.55 % of control subjects were catergorized as ALDH-I deficient. 3) When the results of EPT were compared according to response degrees on each item in two groups, significant items were No. 1, 2, 14. 4) When the results of EPT were compared according to total scores on each dimension in two groups, physiological aversive and psychological aversive dimensions were significantly correlated only in control subjects.