美沙酮维持治疗门诊HIV阳性服药人员吸毒过量死亡的影响因素分析  

Factors associated with overdose-caused mortality of HIV-positive patients who were on methadone maintenance treatment program

作　　者：崔宁[1,2] 曹晓斌[2] 王常合[2] 罗巍[2] 庞琳[2] 柔克明[2] 吴尊友[1] 

机构地区：[1]安徽医科大学公共卫生学院,合肥230032 [2]中国疾病预防控制中心性病艾滋病预防控制中心

出　　处：《中华流行病学杂志》2013年第10期961-963,共3页Chinese Journal of Epidemiology

基　　金：国家“十二五”科技重大专项（2012ZX10001007-002）;中国艾滋病/结核病多学科研究培训项目（5U2RTW006918）

摘　　要：目的分析影响美沙酮维持治疗（MMT）门诊HIV阳性服药人员吸毒过量死亡的因素。方法采用1：1配对病例对照研究方法，对110例因吸毒过量死亡的服药人员与相应对照（与病例同性别、同门诊、首次入组时间相近）的社会人口学、吸毒行为、服药行为等特征进行比较。结果多因素logistic回归模型分析表明，入组前3个月共用针具（OR=5．19，95％CI：1．39～19．33）、经注射吸毒感染HIV（OR=3．08，95％CI：1．16～8．21）、终点前脱失（OR=2．54，95％C1：1．23—5．23）是吸毒过量死亡的危险因素，而治疗依从性好（OR=O．31，95％CI：0．10。0．95）为保护因素。结论应采取综合措施提高MMT门诊服药病例的依从性，并对曾共用针具的病例展开重点干预，从而减少死亡。Objective To study the factors that associated with the mortality of overdose on methadone maintenance treatment （MMT） among HIV-positive patients. Methods A 1 ： 1 matched case-control design was used to identify the relationship between factors related to demography, drug use, characteristics of treatment and the mortality of overdose. 110 HIV-positive patients who died of drug overdose from March 2004 to September 2012 were defined as cases. Controls were another 110 patients who were still alive and paired with the cases, according to the same gender, similar date of MMT initiation and from the same clinics. Results Multivariate conditional logistic regression analyses indicated that risk factors as sharing needles before enrolled in the MMT program （OR= 5.19, 95% CI： 1.39-19.33） , HIV infection because of injecting drug-use （0R=3.08, 95% Ch 1.16-8.21）, and off from the treatment before the end point of the program （0R=2.54, 95%CI： 1.23-5.23 ） were associated with mortality caused by overdose. Higher adherence （OR= 0.31,95%CI.. 0.10-0.95） appeared to be associated with lower mortality when compared with the control group. Conclusion In order to reduce the mortality rate, comprehensive intervention could be introduced to improve the compliance of retention on MMT among patients. Intervention efforts should be focused on those patients who shared needle / syringes.

关 键 词：美沙酮维持治疗 艾滋病病毒 吸毒 死亡 

分 类 号：R749.64[医药卫生—神经病学与精神病学]