酒精依赖患者治疗出院后早期复发的随访调查  

Follow-up investigation of early relapse among alcohol dependent patients after discharge from hospital

作　　者：汪仅 徐沛政 王启 杨梅[1,2] WANG Jin;XU Pei-zheng;WANG Qi;YANG Mei(Shenzhen Clinical College of Mental Health,Anhui Medical University,Shenzhen 518000,Guangdong,China;Shenzhen Kangning Hospital,Shenzhen 518000,Guangdong,China)

机构地区：[1]安徽医科大学深圳精神卫生临床学院,深圳518000 [2]深圳市康宁医院/深圳市精神卫生中心,深圳518000

出　　处：《中国药物依赖性杂志》2022年第5期335-339,345,共6页Chinese Journal of Drug Dependence

基　　金：国家重点研发计划项目(2018YFC1314400);广东省高水平临床重点专科(深圳市配套建设经费)资助(SZGSP013)。

摘　　要：目的探讨酒依赖患者早期复发率,以及人口学因素、躯体共病、门诊随诊对酒依赖复发的影响。方法选择2015年5月22日至2021年3月15日在深圳市康宁医院符合DSM-IV-TR轴I障碍定式临床检查(Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition(SCID-I/P))的479名酒精依赖患者为研究对象,进行基线调查,并在基线后第1、3、6个月进行随访,采用Cox比例风险回归模型分析影响酒精依赖复发的因素。结果酒精依赖患者1个月的复发率37.4%,3个的复发率53.7%,6个月的复发率为64.8%。多因素Cox比例风险回归模型分析发现患有脑梗死(HR=0.632,P=0.018)、居住地(HR=0.674,P=0.001)以及门诊随诊(HR=0.481,P<0.001)是影响酒依赖复发的因素。结论酒依赖患者出院后早期复发率高,而居住在城区及患脑梗死复发的风险低,门诊随诊也有利于保持戒断。Objective The aim of the study was to describe the relapse rate of alcohol dependent patients,and to explore whether demographic factors and somatic comorbidities as well as follow-up outpatient counseling to predict relapse in alcohol dependence.Methods This prospective study followed up 479 patients from May 22,2015 to March 15,2021,who met the Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition(SCID-I/P)in alcohol dependence criteria.The patients were recruited from Shenzhen Kangning Hospital.The participants were interviewed at baseline and followed up by telephone at 1,3,and 6 months.Cox proportional hazard regression model was used to detect the factors affecting the relapse of alcohol dependence.Results The one-month relapse rate of alcohol dependent patients was 37.4%,the 3-month relapse rate was 53.7%,and the 6-month relapse rate was 64.8%.According to Cox multivariate analysis,the cerebral infarction(HR=0.632,P=0.018)and residence(HR=0.674,P=0.001),and outpatient follow-up(HR=0.481,P<0.001)significantly predicted relapse.Conclusion Alcohol dependent patients have a high relapse rate after discharge.Living in urban areas and suffering from cerebral infarction have a low relapse risk,and outpatient counseling is helpful to maintain withdrawal.

关 键 词：酒依赖 早期复发 躯体共病 门诊随诊 影响因素 

分 类 号：R749[医药卫生—神经病学与精神病学]