台州市美沙酮维持治疗人群特征分析
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摘要
目的了解台州市美沙酮维持治疗(MMT)患者的人口学特征及MMT维持率的影响因素。方法从全国MMT数据管理系统导出2006—2014年台州市首次入组MMT的鸦片或海洛因成瘾者信息,对其人口学特征、既往毒品使用情况和MMT治疗情况进行描述性分析,采用Logistic回归模型分析MMT维持率的影响因素。结果 2006—2014年台州市首次入组MMT的鸦片或海洛因成瘾者共2 262例,其中男性1 980例(87.53%),女性282例(12.47%);未婚、离异或丧偶1 261例,占55.75%;初中及以下文化程度2 006例,占88.68%;初次吸毒年龄为9~54岁,平均(25.06±6.34)岁;吸毒时间平均(6.71±4.55)年;1 123例(49.65%)曾有毒品注射行为;81例(3.58%)注射毒品时有共用针具行为;MMT治疗维持时间平均(5.02±2.01)年;治疗期间平均服药剂量为(34.49±22.69)m L。MMT维持率为29.22%(661/2 262),门诊所在地区(OR:1.984~3.445)、患者年龄≥40岁(OR=1.640,95%CI:1.168~2.304)、治疗剂量>20 m L(OR:1.937~2.636)是MMT维持率的影响因素。结论台州市MMT患者以男性、未婚、离异或丧偶、初中及以下文化程度为主;MMT维持率总体较低,≥40岁和治疗剂量>20 m L的患者MMT维持率相对较高。
Objective To investigate the characteristics of methadone maintenance treatment(MMT) clients, and to explore their retention rate and associated factors in Taizhou,Zhejiang Province. Methods Heroin or opiate addicts who started MMT between 2006 and 2014 in study area were included. Data including demographics,history of drug use and treatment information was extracted from the National MMT Data Management System and descriptive analysis were conducted. Multiple logistic regression models were used to explore factors associated with retention rate. Results In total, 2 262 MMT clients were included for analysis. Most of them were male(87.53%),single,divorced or widowed(55.75%),and had an education of junior middle school or below(88.68%). Almost all of them(98.32%) were heroin addicts, and the age at first drug use ranged from 9 years to 54 years,with average age of(25.06±6.34) years. A total of 1 123(49.65%) clients had a history of inject drug use and 81(3.58%) clients had ever shared needles with others. The average duration on MMT was 5.02 ±2.01 years, and the average methadone dosage during treatment was(34.49 ±22.69) m L. The MMT retention rate was 29.2%(661/2 262). In multivariable analysis,districts such as Huangyan District,Yuhuan County and Linhai City,aged≥40 years and average methadone dosage >20 m L during treatment were independently and positively associated with retention rate.Conclusion Most of MMT clients in Taizhou are male,unmarried,and had low education level. The retention rate is low in Taizhou but older patents and those receive high methadone dosage have a relatively higher retention rate.
Objective To investigate the characteristics of methadone maintenance treatment(MMT) clients, and to explore their retention rate and associated factors in Taizhou,Zhejiang Province. Methods Heroin or opiate addicts who started MMT between 2006 and 2014 in study area were included. Data including demographics,history of drug use and treatment information was extracted from the National MMT Data Management System and descriptive analysis were conducted. Multiple logistic regression models were used to explore factors associated with retention rate. Results In total, 2 262 MMT clients were included for analysis. Most of them were male(87.53%),single,divorced or widowed(55.75%),and had an education of junior middle school or below(88.68%). Almost all of them(98.32%) were heroin addicts, and the age at first drug use ranged from 9 years to 54 years,with average age of(25.06±6.34) years. A total of 1 123(49.65%) clients had a history of inject drug use and 81(3.58%) clients had ever shared needles with others. The average duration on MMT was 5.02 ±2.01 years, and the average methadone dosage during treatment was(34.49 ±22.69) m L. The MMT retention rate was 29.2%(661/2 262). In multivariable analysis,districts such as Huangyan District,Yuhuan County and Linhai City,aged≥40 years and average methadone dosage >20 m L during treatment were independently and positively associated with retention rate.Conclusion Most of MMT clients in Taizhou are male,unmarried,and had low education level. The retention rate is low in Taizhou but older patents and those receive high methadone dosage have a relatively higher retention rate.
引文
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[6]王娟,刘国武,赵月娟,等.北京市2010—2014年美沙酮维持治疗门诊患者脱失影响因素分析[J].中华疾病控制杂志,2016,20(8):777-780.
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[10]薛丽燕,许昌麟,潘启超,等.115例海洛因成瘾者社区美沙酮维持治疗一年疗效评估[J].中国药物滥用防治杂志,2006,12(5):255-257.
[11]赵西和,廖克坤,刘世安.绵羊市美沙酮维持治疗者脱失现况分析[J].预防医学情报杂志,2014,30(3):178-180.
[12]李群.美沙酮维治疗效果影响因素的研究进展[J].临床合理用药,2016,9(15):176-177.
[13]陈弘,吴国辉,王小皙.重庆市美沙酮维持治疗患者脱失情况及影响因素分析[J].现代医药卫生,2016,32(11):1612-1614.
[14]YANG F,LIN P,LI Y,et al.Predictors of retention in community-based methadone maintenance treatment program in Pearl River Delta,China[J].Harm Reduct J,2013,10(1):3.
[15]赵世苗,蒋海潮,朱爱珍,等.系统性家庭治疗提高美沙酮维持治疗患者依从性的效果分析[J].预防医学,2017,29(6):599-602.
[2]刘玉琴,许桂英.美沙酮维持治疗患者心理健康及影响因素分析[J].预防医学,2017,29(7):748-749,753.
[3]郑剑,赵丽娜,王大勇,等.温州市美沙酮维持治疗患者生存质量及影响因素研究[J].预防医学,2017,29(8):777-781.
[4]李春霞,王君,潘明虎,等.美沙酮维持治疗人群高危性行为相关因素及交互作用分析[J].中华流行病学杂志,2016,37(6):796-800.
[5]王逸超,李建华.美沙酮维持治疗依从性的研究进展[J].中国药物滥用防治杂志,2013,19(1):37-41.
[6]王娟,刘国武,赵月娟,等.北京市2010—2014年美沙酮维持治疗门诊患者脱失影响因素分析[J].中华疾病控制杂志,2016,20(8):777-780.
[7]龙正元,吴祖英,杜波,等.538例海洛因成瘾者美沙酮维持治疗情况[J].中国药物依赖性杂志,2006,15(1):38-40.
[8]张晓丽,王福生.美沙酮替代治疗者合并肺结核62例临床分析[J].中国防痨杂志,2012,34(2):107-109.
[9]ZHOU K,ZHUANG G.Retention in methadone maintenance treatment in mainland China,2004-2012:a literature review[J].Addict Behav,2014,39(1):22-29.
[10]薛丽燕,许昌麟,潘启超,等.115例海洛因成瘾者社区美沙酮维持治疗一年疗效评估[J].中国药物滥用防治杂志,2006,12(5):255-257.
[11]赵西和,廖克坤,刘世安.绵羊市美沙酮维持治疗者脱失现况分析[J].预防医学情报杂志,2014,30(3):178-180.
[12]李群.美沙酮维治疗效果影响因素的研究进展[J].临床合理用药,2016,9(15):176-177.
[13]陈弘,吴国辉,王小皙.重庆市美沙酮维持治疗患者脱失情况及影响因素分析[J].现代医药卫生,2016,32(11):1612-1614.
[14]YANG F,LIN P,LI Y,et al.Predictors of retention in community-based methadone maintenance treatment program in Pearl River Delta,China[J].Harm Reduct J,2013,10(1):3.
[15]赵世苗,蒋海潮,朱爱珍,等.系统性家庭治疗提高美沙酮维持治疗患者依从性的效果分析[J].预防医学,2017,29(6):599-602.