中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2011年
2期
125-129
,共5页
杨跃诚%段松%项丽芬%叶润华%高洁%杨顺生%杨盈波%龙玉存%李国强%尹棉松%龚渝蓉%杨世江%王继宝%吴尊友%柔克明%何纳
楊躍誠%段鬆%項麗芬%葉潤華%高潔%楊順生%楊盈波%龍玉存%李國彊%尹棉鬆%龔渝蓉%楊世江%王繼寶%吳尊友%柔剋明%何納
양약성%단송%항려분%협윤화%고길%양순생%양영파%룡옥존%리국강%윤면송%공투용%양세강%왕계보%오존우%유극명%하납
美沙酮维持治疗%依从性%脱失%影响因素
美沙酮維持治療%依從性%脫失%影響因素
미사동유지치료%의종성%탈실%영향인소
Methadone maintenance treatment%Adherence%Withdraw%Determinant
目的 了解云南省德宏州2005-2009年间海洛因成瘾者美沙酮维持治疗保持率及其影响因素.方法 以入组治疗时间作为进入队列时间进行动态队列研究,计算不同随访时间美沙酮维持治疗保持率,运用Cox比例风险回归模型分析其影响因素.结果 云南省德宏州2005-2009年间共3758人人组治疗,男性占95.8%;以20～39岁为主,占75.8%;农民和无业者占90.4%;少数民族占57.0%;未婚者占35.0%,已婚有配偶者占55.5%;文盲及小学文化程度者占43.9%.开始吸毒的平均年龄为23.93岁;吸食海洛因占96.3%;有40.6%的吸毒者曾经注射吸毒;有21.7%的吸毒者为HIV感染者.美沙酮服药时间最短者不足1个月,最长61个月;首次服药剂量最小为1 ml,最大为330 ml,中位剂量25 ml.截止观察期末,累计退出治疗1798人,在组治疗1960人;入组治疗后1、3、6、9、12、24、36、48和60个月的累积保持率(%)分别为0.919、0.847、0.756、0.690、0.637、0.519、0.417、0.360和0.321.Cox比例风险回归模型多因素结果显示,研究对象所在治疗点、首次服药年度、婚娴状况、HIV抗体检测结果、首次服药剂量以及最后一次尿检结果与维持治疗保持时间长短有显著关联.结论 德宏州美沙酮维持治疗脱失率较高;应加强对美沙酮维持治疗者相关咨询和宣传教育、加强家庭或社区支持、给予合适的首次美沙酮剂量、并解决好偷吸毒品的问题.
目的 瞭解雲南省德宏州2005-2009年間海洛因成癮者美沙酮維持治療保持率及其影響因素.方法 以入組治療時間作為進入隊列時間進行動態隊列研究,計算不同隨訪時間美沙酮維持治療保持率,運用Cox比例風險迴歸模型分析其影響因素.結果 雲南省德宏州2005-2009年間共3758人人組治療,男性佔95.8%;以20～39歲為主,佔75.8%;農民和無業者佔90.4%;少數民族佔57.0%;未婚者佔35.0%,已婚有配偶者佔55.5%;文盲及小學文化程度者佔43.9%.開始吸毒的平均年齡為23.93歲;吸食海洛因佔96.3%;有40.6%的吸毒者曾經註射吸毒;有21.7%的吸毒者為HIV感染者.美沙酮服藥時間最短者不足1箇月,最長61箇月;首次服藥劑量最小為1 ml,最大為330 ml,中位劑量25 ml.截止觀察期末,纍計退齣治療1798人,在組治療1960人;入組治療後1、3、6、9、12、24、36、48和60箇月的纍積保持率(%)分彆為0.919、0.847、0.756、0.690、0.637、0.519、0.417、0.360和0.321.Cox比例風險迴歸模型多因素結果顯示,研究對象所在治療點、首次服藥年度、婚嫻狀況、HIV抗體檢測結果、首次服藥劑量以及最後一次尿檢結果與維持治療保持時間長短有顯著關聯.結論 德宏州美沙酮維持治療脫失率較高;應加彊對美沙酮維持治療者相關咨詢和宣傳教育、加彊傢庭或社區支持、給予閤適的首次美沙酮劑量、併解決好偷吸毒品的問題.
목적 료해운남성덕굉주2005-2009년간해락인성은자미사동유지치료보지솔급기영향인소.방법 이입조치료시간작위진입대렬시간진행동태대렬연구,계산불동수방시간미사동유지치료보지솔,운용Cox비례풍험회귀모형분석기영향인소.결과 운남성덕굉주2005-2009년간공3758인인조치료,남성점95.8%;이20～39세위주,점75.8%;농민화무업자점90.4%;소수민족점57.0%;미혼자점35.0%,이혼유배우자점55.5%;문맹급소학문화정도자점43.9%.개시흡독적평균년령위23.93세;흡식해락인점96.3%;유40.6%적흡독자증경주사흡독;유21.7%적흡독자위HIV감염자.미사동복약시간최단자불족1개월,최장61개월;수차복약제량최소위1 ml,최대위330 ml,중위제량25 ml.절지관찰기말,루계퇴출치료1798인,재조치료1960인;입조치료후1、3、6、9、12、24、36、48화60개월적루적보지솔(%)분별위0.919、0.847、0.756、0.690、0.637、0.519、0.417、0.360화0.321.Cox비례풍험회귀모형다인소결과현시,연구대상소재치료점、수차복약년도、혼한상황、HIV항체검측결과、수차복약제량이급최후일차뇨검결과여유지치료보지시간장단유현저관련.결론 덕굉주미사동유지치료탈실솔교고;응가강대미사동유지치료자상관자순화선전교육、가강가정혹사구지지、급여합괄적수차미사동제량、병해결호투흡독품적문제.
Objective To determine the adherence to and its determinants of methadone maintenance treatment (MMT) among heroin addicts in Dehong prefecture in Yunnan province from 2005 to 2009. Methods A dynamic cohort analysis was conducted with the time of treatment initiation as the time of cohort entry, to calculate the proportion of adhering to the treatment at different time points after initiation of the treatment, and to study the determinants of adherence.Results A total of 3758 had been treated. Among them, 95.8% were males, 75.8% aged between 20-39 years, 90.4% were peasants or unemployed, 57.0% were ethnic minorities, 35.0% were single and 55.5% were married with spouses, 43.9% were illiterate or educated at most primary school. The age of first using drugs averaged at 23.93 years. About 96.3% of the study subjects had used heroin and 21.7% were HIV-infected. The minimum time under MMT was less than 1 month and the maximum 61 months. The median methadone dose at first delivery was 25 ml, with the minimum 1 ml and the maximum 330 ml. By the end of the study or observation period, a total of 1798 patients had withdrawn from treatment and 1960 were still under treatment. The proportions of adherence to or still being under the treatment after 1,3,6,9, 12,24, 36,48 and 60 months treatment were 0.919,0.847,0.756, 0.690, 0.637, 0.519, 0.417, 0.360 and 0.321, respectively. Multiple regression analysis using Cox proportional hazard model indicated that withdraw from the methadone maintenance treatment was significantly associated with location of the treatment clinics, year of treatment initiation, marital status, HIV infection status, methadone dose of first delivery and the result of last urine test for heroin use. Conclusion MMT attendants in Dehong prefecture had a relatively high withdraw rate and low adherence rate. More efforts are needed to provide tailored counseling and education to MMT attendants, to provide family and community support, appropriate methadone dose at first delivery, and to better coordinate with local police department.
