海洛因依赖者美沙酮维持治疗前后肝肾功能检测结果分析  

Analysis on hepatonephric function test results before and after methadone maintenance therapy among heroin addicted people

作　　者：胥加耕 李志勇[1] 袁中行 刘庆勇[1] 闫琳[1] 王芳[1] 

机构地区：[1]盐城市盐都区疾病预防控制中心,江苏盐城224002

出　　处：《现代预防医学》2016年第8期1440-1443,1457,共5页Modern Preventive Medicine

基　　金：江苏省卫生厅预防医学科研课题(Y201006)

摘　　要：目的探讨海洛因依赖者美沙酮维持治疗(MMT)前后肝肾功能的变化情况及其影响因素。方法对盐城市美沙酮门诊病人入组时及维持治疗1年后进行检测的血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿素(UREA)和肌酐(Cr)结果进行统计分析。结果 299例海洛因依赖者MMT前ALT、AST、UREA、Cr异常率分别为35.12%、31.44%、1.00%和0.67%,男性、HCV抗体阳性是MMT前ALT异常的危险因素,年龄、HCV抗体阳性是MMT前AST异常的危险因素。173例海洛因依赖者接受MMT 1年后ALT、AST的检测结果(t ALT=2.901,P=0.004;t AST=2.836,P=0.005)和异常率(ALT=4.504,P<0.05;AST=7.268,P<0.01)均显著下降,男性、低年龄段、HCV抗体阳性及入组时ALT异常是维持治疗后ALT异常的危险因素,HCV抗体阳性也是治疗后AST异常的危险因素。维持治疗前后肾功能无明显变化。结论海洛因依赖者肝功能损害者比例较高,美沙酮维持治疗可有效改善肝损害。Objective The aim of this study was to discuss the hepatonephric function parameters change and the influencing factors for heroin addicts before and after methadone maintenance therapy（ MMT）. Methods ALT,AST,UREA and Cr were detected among the addicts at methadone maintenance treatment clinics in Yancheng city before and after MMT,and analysis was made based on the results. Results Abnormal rates of ALT,AST,UREA and Cr among 299 MMT patients before treatment were 35. 12%,31. 44%,1. 00% and 0. 67%,respectively. Male and hepatitis C were the risk factors for abnormal ALT. Hepatitis C was also the risk factor for abnormal AST before MMT. Detection results（ t ALT = 2. 901,P = 0. 004; t AST= 2. 836,P = 0. 005） and abnormal rates（ ALT = 4. 504,P〈0. 05; AST = 7. 268,P〈0. 01） of ALT and AST were significantly decreased one year after MMT among 173 addicts. The risk factors for abnormal ALT after MMT were male,low-age,hepatitis C and ALT before MMT. Hepatitis C was the risk factor for abnormal AST after MMT. There were no changes of kidney function before and after MMT. Conclusion Heroin addicts have high liver injury rates. MMT can be an effective measure in reducing their liver damage and improve liver function.

关 键 词：海洛因依赖者 美沙酮维持治疗 肝肾功能 影响因素 

分 类 号：R183[医药卫生—流行病学]