广西灵山县美沙酮维持治疗点2007-2011年保持率及影响因素分析  

Adherence rate and related factors of methadone maintenance treatment among heroin addicts in Lingshan,Guangxi

作　　者：黄玉满[1] 唐振柱[1] 刘伟[1] 黎伯东[2] 蓝光华[1] 李荣健[1] 陈锦妹 

机构地区：[1]广西壮族自治区疾病预防控制中心,广西南宁530028 [2]灵山县疾病预防控制中心,广西钦州535400

出　　处：《中华疾病控制杂志》2012年第12期1036-1039,共4页Chinese Journal of Disease Control & Prevention

基　　金："十一五"国家科技重大专项(2008ZX10001-016)

摘　　要：目的了解广西灵山县2007-2011年间海洛因成瘾者美沙酮维持治疗(methadone maintenancetreatment,MMT)保持率的情况,并探讨其影响因素。方法数据来自全国艾滋病综合防治信息系统中的社区MMT数据库,以入组治疗时间作为进入队列时间进行历史性队列研究,计算不同年份MMT保持率,运用COX比例风险回归模型分析其影响因素。结果广西灵山县2007-2011年间共996人入组治疗,男性为主,占92.17%;平均年龄为(33.7±6.6)岁;待业/无业者居多,占38.25%;初中及以下文化程度者占93.98%。最近1次尿检阳性者占70.98%;HIV阳性者401人,感染率为40.26%;MMT保持时间最短者不足1个月,最长60个月。截止观察期末,第1年到第5年的保持率分别为51.8%、50.8%、65.4%、76.6%和72.0%。累计退出治疗1 256人次,主要原因为无故7 d不治疗,占40.76%。多因素分析结果显示:研究对象的性别、职业、文化程度、开始吸毒年龄最后1次尿检结果以及HIV抗体检测结果与维持治疗保持时间长短关联有统计学意义。结论自2006年以来灵山县MMT保持率总体呈上升趋势,但反复进入和退出的人次较多,脱失率较高。因此,应加强对MMT者的咨询、宣传和关怀等社会工作,并解决好偷吸毒品问题。Objective To explore the adherence rate and its influencing factors of methadone maintenance treatment（MMT） among heroin addicts in Lingshan County of Guangxi from 2007 to 2011.Methods Data were from the ＂Community Methadone Maintenance Treatment＂ database of ＂AIDS Prevention and Control Information System＂.A historical cohort study was carried out based on the time of enrollment as the queue time.The MMT retention rates of different years were then calculated;Factors affecting MMT adherence were analyzed by the use of COX proportional hazards regression model.Results During 2007-2011,a total number of 996 patients were enrolled for treatment.Among them,92.17% were males.The averaged age was（33.7±6.6） years old.38.25% were jobless,and 93.98% of them had a middle school education level or even lower.70.98% were positive for morphine test in the last time.401 were HIV positive,accounting for 40.26%.The minimum time under MMT was less than l month and the maximum time was 60 months.By the end of observation period,detention rates of 1st,2nd,3rd,4th and 5th year were 51.8%,50.8%,65.4%,76.6% and 72.0%,respectively.During the whole study,1 256 person-times of patients were considered as withdrawal due to the absence of treatment without reasons,which was occupied 40.76%.COX multiple factors analysis showed that the retention rate of MMT treatment is statistically associated with gender,occupation,education level,urine test result in the last time as well as HIV antibody detection.Conclusions MMT retention rate has showed an upward trend since 2006.However,quite a number of patients enrolled but withdrew from treatment again and again,leading to a relatively high dropout rate.As a result,counseling,education and social work on MMT should be strengthened.Moreover,the relapse issue among drug users should be addressed.

关 键 词：HIV 队列研究 流行病学方法 

分 类 号：R181.1[医药卫生—流行病学] R512.91[医药卫生—公共卫生与预防医学]