美沙酮维持治疗海洛因依赖者的30天功能及影响因素  

30-DAY FUNCTIONING AND ASSOCIATED FACTORS OF HEROIN ADDICTS RECEIVING METHADONE MAINTENANCE TREATMENT

作　　者：柳小波[1] 钟宝亮[1] 朱军红[1] 

机构地区：[1]华中科技大学同济医学院附属精神卫生中心,武汉430022

出　　处：《中国药物依赖性杂志》2014年第1期43-50,共8页Chinese Journal of Drug Dependence

摘　　要：目的:探索美沙酮维持治疗(MMT)海洛因依赖者的30天功能受损情况及其影响因素。方法:603例MMT门诊海洛因依赖者完成社会人口学特征问卷、30天功能问卷、躯体健康自评、Zung氏抑郁自评量表、Zung氏焦虑自评量表和匹兹堡睡眠质量指数及报告个人身高体重;另从3所综合医院募集360例非精神/心理科门诊患者以作为海洛因依赖者的普通躯体疾病患者对照,由其自评完成社会人口学特征问卷和30天功能问卷;用多分类有序因变量Logistic回归筛选对象功能受损的危险因素。结果:MMT门诊海洛因依赖者近一个月轻度和中重度功能受损检出率显著高于综合医院门诊普通躯体疾病患者(轻度和中重度功能受限:31.8%和30.3%vs.14.7%和9.2%,χ2=134.5,P<0.001;轻度和中重度功能丧失:16.4%和11.3%vs.10.0%和7.8%,χ2=12.3,P=0.002);海洛因依赖者功能受限程度加重与无工作(OR:1.34)、婚姻不良(OR:1.60)、MMT剂量81-156 mg·d-1(OR:1.75)、酒精使用(OR:1.48)、焦虑(OR:2.30)和身体健康自评差或很差(OR:3.90)显著相关;海洛因依赖者功能丧失程度加重与女性(OR:1.81)、有宗教信仰(OR:1.85)、抑郁(OR:1.43)、身体健康自评差或很差(OR:1.55)和超重及肥胖(OR:2.21)显著相关。结论:MMT海洛因依赖者功能受损情况较普通躯体疾病患者严重;有必要采取综合性的生物-心理-社会干预措施,方能有效改善MMT门诊海洛因依赖者的功能受损状况。Obective： To explore the 30 -day functioning impairment and its related factors of heroin addicts receiving methadone maintenance treatment （MMT）. Methods：Six hundred and three heroin addicts, who were recruited from MMT outpatients, completed socio -demographic questionnaire, 30 - day Functioning Questionnaire, self- reported physical health item, Zung＇ s Self- rating Depression Scale, Zung＇ s Self- rating Anxiety Scale and Pittsburgh Sleep Quality Index, and reported their personal height and weight. In addition, 360 physically ill patients, who were recruited from outpatients of three general hospitals to be control group, were also administered with socio -demographic questionnaire and 30 -day Functioning Questionnaire. Ordinal Logistic Regression was used to identify factors associated with functioning impairment. Results ： The prevalence rates for mild and moderate - to - severe functioning impairment of heroin addicts were significantly higher than those of physically ill controls （mild and moderate - to - severe restricted function： 31.8% and 30.4% vs. 14. 7% and 9.2%,χ2 = 134.5, P 〈 0.001 ; mild and moderate -to -severe function loss： 16.4% and 11.3% vs. 10. 0% and 7. 8% ,χ2 = 12. 3,P = 0. 002 ）. The increased severity of restricted function in heroin addicts was significantly associated with unemployment （ OR ： 1.34）, poor marital status （ OR ： 1.60）, a MMT dose of 81 - 156 mg . d-1 （ OR ： 1.75 ）, alcohol use （ OR： 1.48 ）, anxiety （ OR ： 2.30） and bad or very bad self -reported physical health （ OR： 3.90）, whereas, the elevated severity of function loss in heroin addicts was significantly correlated with female in gender （ OR： 1.81 ）, religious belief （ OR： 1.85）, depression OR ： 1.43） , bad or very bad self - reported physical health （OR ： 1.55） and over - weight or obesity OR： 2. 21 ）. Conclusion： Heroin addicts, who are receiving MMT, have more severe functioning impairment than physically ill patients. There

关 键 词：功能受损 美沙酮维持治疗 海洛因依赖 

分 类 号：R595.5[医药卫生—内科学]