基于生存分析的美沙酮维持治疗患者脱失及影响因素研究  

Research on Patients dropping out and its influence factors in Community-based Methadone Maintenance Treatment

作　　者：姜世强[1] 严燚[1] 杨长贵[2] 牛姬飞[3] JIANG Shiqiang YAN Yi YANG Changgui NIU Jifei(Center of Disease Control and Prevention of Nanshan District, Shenzhen Guangdong 518054, China)

机构地区：[1]深圳市南山区疾病预防控制中心,广东深圳518054 [2]深圳市福田区人民医院第三分院 [3]深圳市福田区疾病预防控制中心

出　　处：《河南预防医学杂志》2017年第4期245-249,共5页Henan Journal of Preventive Medicine

基　　金：深圳市卫生计生委医疗卫生类科研项目(NO.201303195);深圳市南山区医疗卫生科研项目(NO.2013071);福田区卫生公益性科研项目(FTWS201348)

摘　　要：目的探讨美沙酮维持治疗患者脱失及其影响因素,为提供干预措施提供科学依据。方法收集福田区和南山区2009-2014年所有美沙酮维持治疗患者相关信息,使用Kaplan-Meier法进行单因素分析,根据单因素结果选择有意义的变量进入Cox比例风险模型进行生存分析。结果共收集694例研究对象,5年累计脱失率为82.42%,研究发现无业,独居,靠临时工资生活,公安部门介绍参加治疗,静脉和其他方式混合吸毒,吸毒年限在10~15 a,日服用剂量≤30mL,合并感染丙肝,梅毒或艾滋病均为美沙酮维持治疗门诊患者脱失的危险因素。结论美沙酮门诊脱失率较高,严重影响门诊治疗效果,应根据危险因素,提供针对性的干预措施,有效降低门诊脱失率。Objective To investigate the patients dropping out and its influence factors in community-based methadone maintenance treatment（MMT） and provide scientific basis for intervention measure.Methods Collecting the relevant information of patients in MMT of Futian and Nanshan from 2009 to 2014,and using survival analysis to find the risk factors of patients dropping out in MMT.Results A total of 694 cases were collected,the cumulative dropping out rate was 82.42%.The risk factors of dropping out include unemployed,solitary,living on a temporary wage,participating in treatment from police introduction,pattern of drug abuse,the length of drug abuse,treatment dose ≤30 mL,coinfection with HIV/HBV/syphilis.Conclusions High dropout rate will seriously affect the treatment quality of MMT,we should provide the targeted intervention measures according the risk factors to decrease the dropping out rate effectively.

关 键 词：美沙酮维持治疗 脱失 生存分析 

分 类 号：R163.3[医药卫生—公共卫生与预防医学]