四川省西昌市静脉吸毒人群3年随访的死亡情况分析  

A 3-Year Prospective Cohort Study on Mortality among Injecting Drug Users in Xichang County

作　　者：朱玉[1] 尹潞[2] 阮玉华[2] 郝春[2] 姚辉鸣 杨学贵[1] 边会珍 陈康林[1] 刘莉[1] 冯成玉[1] 秦光明[3] 邵一鸣 

机构地区：[1]西昌市皮肤病性病防治站,四川615000 [2]中国疾病预防控制中心性病艾滋病预防控制中心和传染病预防控制国家重点实验室 [3]四川省疾病预防控制中心

出　　处：《中国自然医学杂志》2006年第3期170-174,共5页Chinese Journal of Natural Medicine

基　　金：国家十五科技攻关课题项目(2004BA719A01;2004BA719A02);国家自然科学基金项目(30571612;10501052);卫生部艾滋病防治应用性研究项目(WA2003-13);全球基金第四轮中国艾滋病项目应用性研究项目(2005GF4RW002)

摘　　要：目的了解四川省凉山彝族自治州西昌市静脉吸毒人群死亡率及死因情况。方法于2002年11月招募静脉吸毒人群前瞻性研究队列376人，调查其社会人口学、吸毒行为和性行为特征。计算静脉吸毒人群3年随访的死亡率和死因构成，对其影响因素采用单因素和多因素Cox回归模型分析。结果在队列3年随访中，死亡44人，死亡率为42．60／1000人年（95％CI：30．02～55．19），标准化死亡比为27．35（95％CI：15．66～46．24）。吸毒过量占全部死因的68．2％（30／44）。多因素Cox回归模型分析未见与全死因有统计学意义的变量，但见吸毒年限≥10年（RR值，3．04；95％CI：1．42～6．50；P=0．0041）和近3个月静脉注射频率≥7次／周（RR值，2．70；95％CI：1．24～5．89；P=0．0127）与吸毒过量死亡差异有统计学意义。结论吸毒过量是西昌市静脉吸毒人群的主要死因，需进一步探讨吸毒过量死亡的影响因素及其干预对策。Objective To study the mortality in the 3 - year follow - up study of injecting drug users （IDUs） in Liangshan of Sichuan Province. Methods In November 2002, a community - based survey was conducted to recruit 376 IDUs for a prospective cobert study. Socio - demographics and high risk behavior was collected through interview questionnaire. Factors associated with the mortality rate in the 3 - year follow - up study were analyzed with univariate and multivariate Cox regression model. Results A total of 44 deaths were found during the 3 - year follow - up study. The mortality rate of the cohort was 42.60 per 1 000 person - year （95% CI： 30.02～55.19） with the standardized mortality ratio （SMR） as 27.35 （95% CI： 15.66～46.24）. Out of the 44 deaths, 68.2% （30） caused by heroin overdoses. No variables were found to be associated with death of all cases, but ≥ 10 year history of heroin use （Hazard Ratio RR, 3.04; 95% CI： 1.42～6.50; P = 0.004 1）, and drug injection past 3 months （RR, 2.70; 95% CI： 1.24～5.89; P = 0.012 7） were found to be associated with overdose - related mortality in the final Cox regression model. Conclusion Overdose served as the most frequent cause of death in Liangshan of Sichuan Province. Future studies should be conducted to focus on mortality and risk factors associated with mortality among IDUs to provide targeted interventions in reducing unnatural mortality.

关 键 词：静脉吸毒人群 前瞻性队列研究 死因 标准化死亡比 吸毒过量 

分 类 号：R512.910.1[医药卫生—内科学]