美沙酮维持治疗者脱失影响因素的病例对照研究  

Factors associated with dropout of methadone maintenance treatment clinics:a case-control study

作　　者：戴明妹 陈国红[2] 程曌 徐杰[1] 殷文渊[1] 曹晓斌[1] DAI Mingmei;CHEN Guohong;CHENG Zkao;XU Jie;YIN Wenyuan;CAO Xiaobin(National Center for AIDS/ STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China;Department of AIDS /STD Prevention and Control, Jiangsu Provincial Center for Diseases Prevention and Control, Nanjing 210009)

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]江苏省疾病预防控制中心性病艾滋病防治所,南京210009

出　　处：《中国艾滋病性病》2018年第5期478-481,490,共5页Chinese Journal of Aids & STD

基　　金：社区美沙酮维持治疗关怀项目(R01DA033130)~~

摘　　要：目的分析美沙酮维持治疗（MMT）门诊服药人员脱失的影响因素,为干预工作的开展提供针对性建议。方法采用病例与对照1∶1匹配的研究设计,病例为过去一年在门诊参加过治疗,但研究开始时已退出治疗者,对照为过去一年在门诊参加过治疗且研究开始时仍在治疗者。研究对象共147对,来自江苏省5个MMT门诊。对病例组与对照组在一般人口学特征、既往药物滥用特征、治疗相关特征等方面进行了比较,运用条件Logistic回归模型对可能会对MMT脱失产生影响的因素进行了分析。结果147对（294名）研究对象平均年龄为（44.8±7.1）岁,男性占74.1%（218/294）。多因素条件Logistic回归分析表明,与吸毒朋友交往频繁[比值比（OR）=36.82,95%可信区间（CI）：4.72~287.54）、治疗期间偷吸毒品（OR=5.59,95%CI：1.89~16.55）、往返门诊在1个小时及以上（OR=3.22,95%CI：1.08~9.64）会增加MMT脱失风险;50岁及以上年龄组（OR=0.01,95%CI：0.01~0.20）、治疗依从性高（OR=0.21,95%CI：0.05~0.87）能降低脱失的风险。结论应根据不同的影响因素,采取有针对性的干预措施,提高MMT门诊受治者的依从性,降低脱失率。Objective To explore the factors associated with dropout of the community-based methadone maintenance treatment（MMT）patients.Methods A 1∶1 matched case-control design was used with one group of dropout as the study group and another receiving consistent MMT as controls in May 2017.Totally 147 pairs of patients from 5 MMT clinics in Jiangsu were included in the study.Logistic regression models were used to identify the factors related to dropout,including demographics,drug use,and characteristics of MMT.Results 147 pairs were included with the average age of 44.8±7.1 years and 74.1% male.Multivariate conditional logistic regression models indicated that frequent contact with drug users（OR=36.82,95%CI：4.72-287.54）,use of heroin during MMT（OR=5.59,95%CI：1.89-16.55）,one hour or more of the round-trip for MMT（OR=3.22,95% CI：1.08-9.64）might increase the risks of dropout of MMT significantly;while age of 50 years and above（OR=0.01,95%CI：0.01-0.20）and high adherence（OR=0.21,95%CI：0.05-0.87）might be associated with lower dropout of MMT.Conclusion In order to reduce the dropout rate and improve the retention,comprehensive intervention should be introduced to MMT services.

关 键 词：美沙酮维持治疗 脱失 病例对照 

分 类 号：R512.91[医药卫生—内科学]