苯丙胺类、阿片类和酒依赖者住院后结局与影响因素研究  

Study on Outcomes and Influencing Factors of Amphetamines,Opioids and Alcohol-dependent Patients after Hospitalization

作　　者：润海燕[1] 李英 王爱民 谢玉虹 陆秋艳 杨梅 RUN Hai-yan;LI Ying;WANG Ai-min;XIE Yu-hong;LU Qiu-yan;YANG Mei(Department of Chronic Rehabilitation,Shenzhen Kangning Hospital,Shenzhen 518000 China)

机构地区：[1]深圳市康宁医院慢性康复科,广东深圳518000

出　　处：《内蒙古医学杂志》2020年第5期516-520,共5页Inner Mongolia Medical Journal

基　　金：广东省自然科学基金项目(编号:2018A0303130038)。

摘　　要：目的了解住院治疗的酒精与毒品(苯丙胺类、阿片类)依赖者出院后的结局情况。方法采用自制调查表收集322例患者的基线资料,包括社会人口学、物质使用临床特征、精神/躯体共病,住院天数等。采用现场访谈和查阅病历相结合方式完成基线资料采集。随访时间点设在出院后1、3和6月。通过电话形式对患者和其家属/护送人进行结构式访谈,重点询问患者在随访期内是否戒断门诊随诊、以及复发时间等。结果三类物质中苯丙胺依赖者在精神分裂症的患病率高于阿片类和酒依赖者。在躯体疾病方面,除感染血液/性传播疾病在苯丙胺类依赖组中最高外,其它各类躯体疾病均以酒依赖者患病率为最高。出院后1、3、6月随访时,酒依赖者的持续戒断率和现戒断率,均低于苯丙胺类和阿片类依赖者(P<0.05)。在出院后6个月,苯丙胺类、阿片类、酒依赖者的持续戒断率分别为64.8%、61.5%和38.2%。持续戒断的预测因素中发现酒依赖者出院后门诊随诊者复发风险较低(HR=0.316,P=0.000)。苯丙胺依赖者中出院后门诊随诊与复发风险较低有关(HR=0.22,P=0.002)。结论酒依赖者住院治疗后的半年戒断率不足40%,而苯丙胺类和阿片类依赖者住院治疗后半年戒断率超过60%,提示急需改进酒依赖者的治疗康复策略。出院后继续门诊咨询是酒精依赖、苯丙胺类依赖者出院后不复发的强保护因素。Objective To understand the outcome of hospitalized alcohol and drug(amphetamine,opioid) dependent patients after discharge.Methods A self-made questionnaire was used to collect baseline data of 322 patients,including sociodemiology, clinical characteristics of substance use, mental/physical comorbidities, and length of hospital stay. Baseline data collection was completed using a combination of on-site interviews and medical records. The follow-up time was set in January, March and June after discharge. A structured interview was conducted by telephone with the patient and his/her family members/escorts,focusing on asking the patient whether to withdraw from the outpatient clinic during the follow-up period and the time of relapse.Results The prevalence of amphetamine-dependent patients in the three categories was higher in schizophrenia than in opioids and alcohol-dependent patients.In terms of physical diseases, except for those with blood/sexually transmitted diseases, which are the highest in the amphetamine-dependent group, alcohol-dependent individuals have the highest prevalence of other types of physical diseases. At follow-up in January, March,and June after discharge, the continuous and current withdrawal rates of alcohol-dependent patients were lower than those of amphetamine-and opioid-dependent patients(P<0.05).Six months after discharge, the sustained abstinence rates of amphetamines,opioids, and alcohol dependents were 64.8%, 61.5%, and 38.2%, respectively.Predictors of persistent withdrawal found that alcohol addicts had a lower risk of recurrence in outpatient visits after discharge(HR=0.316,P=0.000).Out-patient follow-up after discharge from amphetamine-dependent patients was associated with a lower risk of recurrence(HR=0.22,P=0.002).Conclusion The half-year withdrawal rate of alcohol-dependent patients after hospitalization is less than 40%, and the half-year withdrawal rate of amphetamines and opioid-dependent patients exceeds 60% after hospitalization. Continued outpatient consultation afte

关 键 词：苯丙胺类 阿片类 持续戒断率 影响因素 

分 类 号：R749.62[医药卫生—神经病学与精神病学]