研究背景: ALDH2*2對偶基因型已被證實為酒癮之保護因子，此保護效果部分來自於飲酒後血中乙醛濃度之升高，及其所導致之生理不適感，包含周邊血管擴張、頭暈、噁心、嘔吐及臉紅等。目前已有研究支持酒精效果預期為ALDH2基因型影響飲酒行為之中介變項。之前研究較少著重於具不同ALDH2基因型之酒癮患者其酒精效果預期的探討，因此本研究之目的為探討酒精效果預期、酒癮渴求及飲酒量於ALDH2*1/*2及ALDH2*1/*1之酒癮患者間是否有差異。

　　研究方法: 本研究為橫斷面研究，個案取樣自六家醫療院所，共收案九十八名符合DSM-IV酒精依賴診斷準則之個案，並以酒精預期量表、酒癮渴求量表及飲酒行為測量表施測。

　　結果: 整體而言，ALDH2*1/*2之酒癮組之負向酒精效果預期較ALDH2*1/*1之酒癮組顯著為低，於社交人際層面及個人情緒及身體層面兩個分量表得分亦較低。此外，ALDH2*1/*2之酒癮組的正向酒精效果預期較ALDH2*1/*1之酒癮組為高，且於放鬆或減低緊張度之分量表上得分亦較高。此二組於酒癮渴求及飲酒量上並無差異。

　　結論: 雖然於過去針對非酒癮者之研究中，ALDH2*2對偶基因型被認為與負向生理反應有關，但ALDH2*1/*2之酒癮者其正向酒精效果預期反而較高而負向酒精效果預期卻較低，顯示ALDH2*1/*2之酒癮者不僅克服乙醛升高之生理反應而成為酒癮，在認知上，他們亦對飲酒有較高之正向預期及較低之負向預期。未來應可針對不同基因型之酒癮者，量測並比較不同血中乙醛濃度時之生理及心理反應，以更了解乙醛於酒癮形成中所扮演的角色。

　　Objective: This study was designed to examine the relationship between the ALDH genotype and alcohol outcome expectancies, craving, and the amount of alcohol consumed among alcoholics.

　　Method: All alcoholic participants were divided into two groups by their ALDH2 genotype, and we examined if there are differences in their alcohol outcome expectancies, craving or amount of alcohol consumed which were assessed by the Alcohol Expectancies Scale (AES), Alcohol craving scale and Form 90, respectively.

　　Results: The ALDH2*1/*2 group had lower negative alcohol expectancies. In social/interpersonal, emotional, physical and cognitive aspects, they expected less negative impacts than did the ALDH2*1/*1 group. Even more surprisingly, the ALDH2*1/*2 group had higher positive expectancies and they expected higher effects in sexual enhancement, physical and social pleasure, relaxation, and tension reduction. Interestingly, the two groups did not differ in alcohol craving or in amount of alcohol consumed.

　　Conclusion: Although the ALDH2*2 allele is a protective factor against being alcoholic in normal subjects, due in part to the elevated blood level of acetaldehyde and its accompanying physiological discomfort after drinking, once people become alcoholics, they will have the ability to tolerate or inhibit the adverse effects of elevated acetaldehyde, or can even experience a euphoric feeling after an accumulation of acetaldehyde. A future study to make a correlation between the blood levels of acetaldehyde and the physiological response and perception of alcoholics is needed. The differential response to acetaldehyde between alcoholics and non-dependent people with the ALDH2*1/*2 or ALDH2*2/*2 genotype also have to be addressed.

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