不同类型美沙酮维持治疗门诊的海洛因依赖者偷吸海洛因情况及其影响因素  

Risk factors associated with heroin use among patients from two types of methadone maintenance treatment clinics

作　　者：张广[1] 杨跃诚 唐仁海 胡翼云[1] 薛珲[1] 段松 孙江平[1] 

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [2]云南省德宏傣族景颇族自治州疾病预防控制中心艾滋病防治科,云南芒市678400

出　　处：《中国艾滋病性病》2016年第2期106-110,共5页Chinese Journal of Aids & STD

摘　　要：目的了解不同类型美沙酮维持治疗门诊的服药人员海洛因偷吸情况及其影响因素。方法对云南省德宏州5个县（市）的5个美沙酮维持治疗门诊（MMT）和1 7个拓展服药点中,462名美沙酮维持治疗者进行10个月的随访调查,分析MMT门诊和拓展服药点服药人员的基本人口学信息、治疗前吸毒行为、生活质量、尿吗啡检测结果;应用广义估计方程（GEE）,对影响新入组研究对象尿吗啡检测结果阳性的因素进行分析。结果 462例研究对象中,223例来自拓展服药点,239例来自MMT门诊;男性451例（97.6%）,中位平均年龄为（37.8±9.1）岁,汉族占40.7%（188例）。拓展服药点研究对象随治疗时间延长,尿吗啡阳性率下降（χ^2=43.352,P〈0.001）。多因素分析结果显示,拓展服药点的、治疗前1个月有注射吸毒行为的、治疗后自我感觉与家人的关系差的研究对象,其尿吗啡检测阳性的风险,分别高于MMT门诊者、无注射吸毒行为者、自我感觉与家人的关系一般者。结论拓展服药点服药人员随访期间尿吗啡阳性率随服药时间延长有下降趋势。但拓展服药点的研究对象尿吗啡检测阳性的风险高于MMT门诊,应加强家庭和社区的监督与配合作用。Objective To determine the proportion of heroin use among the patients receiving methadone maintenance therapy（MMT） provided by different clinics and identify the risk factors associated with heroin use.Methods A total of 462 heroin addicts from 5 MMT clinics and 17 extension MMT clinics located in Dehong prefecture,Yunnan province were interviewed,and followed up for 10 months.The demographic characteristics,previous drug using behavior,quality of life,urine testing results for morphine of the patients between the extension MMT clinic and standard MMT clinic were collected and compared.The risk factors associated with continued heroin use among the new clients were analyzed with Generalized Estimating Equation.Results Among the 462 clients of clinics,with 223 from extension MMT clinics,239 from MMT clinics,97.6%（451/462） of them were male,with the median age of 37.8±9.1 years old,and 40.7%（188/462） of Han nationality.The positive detection rate of urinemorphine testing decreased with the period of treatment lengthened（χ~2=43.352,P〈0.001）.The results of multivariable analysis showed that the clients of extension MMT clinics,who had injection drug use one month before treatment,and felt they had a bad relationship with their family members,had higher risk of positive urine test compared with those of MMT clinics,who had no injection drug use and felt they had normal relationship with their family members.Conclusion The heroine use among the clients in MMT clinics decreased with period of treatment lengthened.The risk of heroin use among extension MMT clinics was higher.The client＇s family and community should strengthen their cooperation for better supervision and support of MMT.

关 键 词：美沙酮维持治疗 海洛因依赖 影响因素 

分 类 号：R512.91[医药卫生—内科学]