美沙酮维持治疗者乙型肝炎疫苗接种依从性影响因素及交互作用分析  

Influencing factors and interaction of adherence of hepatitis B vaccine in patients receiving methadone maintenance treatment

作　　者：高艺卓 姚添 董爽 武媛婷 刘渊 武俊华 薛通川 冯永亮 王素萍[1,2] GAO Yi-zhuo;YAO Tian;DONG Shuang;WU Yuan-ting;LIU Yuan;WU Jun-hua;XUE Tong-chuan;FENG Yong-liang;WANG Su-ping(Department of Epidemiology,School of Public Health,Shanxi Medical University,Taiyuan Shanxi 030001,China;不详)

机构地区：[1]山西医科大学公共卫生学院流行病学教研室,山西太原030001 [2]山西医科大学临床流行病学与循证医学中心 [3]山西医科大学第一医院 [4]山西省强制隔离戒毒所美沙酮维持治疗门诊 [5]山西省一○九医院美沙酮维持治疗门诊 [6]山西省杏花岭区中心医院美沙酮维持治疗门诊

出　　处：《现代预防医学》2023年第4期711-717,共7页Modern Preventive Medicine

基　　金：国家科技重大专项(2018ZX10721202)。

摘　　要：目的了解美沙酮维持治疗者乙肝疫苗接种依从性,探讨其影响因素和交互作用。方法在前期随机对照试验研究的基础上,通过面对面问卷调查和资料查阅收集303名美沙酮维持治疗者的一般人口学特征、既往乙肝疫苗接种史、美沙酮维持治疗情况和乙肝疫苗全程接种情况等,采用χ^(2)检验或Fisher确切概率法、非条件logistic回归、相加和相乘模型进行统计分析。结果15.18%(46/303)患者乙肝疫苗接种不依从。控制混杂因素后,年龄在45岁以下(OR=2.340,95%CI:1.192~4.593)和既往美沙酮维持治疗中有脱失(OR=2.357,95%CI:1.065~5.217)的美沙酮维持治疗者乙肝疫苗接种不依从的风险较高,收入水平在5000元以下(OR=0.490,95%CI:0.249~0.966)和按乙肝疫苗短程方案(0-1-220/60μg)接种(OR=0.388,95%CI:0.200~0.752)的美沙酮维持治疗者乙肝疫苗接种不依从的风险较低。交互作用结果显示,年龄与收入水平、收入水平与乙肝疫苗接种方案和既往美沙酮维持治疗中脱失与乙肝疫苗接种方案存在相加或相乘交互作用。结论美沙酮维持治疗者乙肝疫苗接种依从性不佳,年龄、收入水平、既往美沙酮维持治疗中脱失和乙肝疫苗接种方案是美沙酮维持治疗者乙肝疫苗接种依从性的影响因素,且因素间的交互作用会增加患者不依从的风险。Objective To investigate the adherence of hepatitis B vaccine in patients receiving methadone maintenance treatment,and to explore the influencing factors and their interactions.Methods Based on the previous randomized controlled trial,face-to-face questionnaire surveys and information records were used to collect the general demographic characteristics,history of previous hepatitis B vaccine,methadone maintenance treatment condition and completion of the hepatitis B vaccine in 303 patients receiving methadone maintenance treatment.And χ^(2) test or Fisher’s exact test,unconditional logistic regression model,additive and multiplicative models were used for statistical analysis.Results 15.18%(46/303)patients did not complete the hepatitis B vaccine.After adjusting for the confounding factors,patients under 45 years of age(OR=2.340,95%CI:1.192-4.593)and with the drop-out of previous methadone maintenance treatment(OR=2.357,95%CI:1.065-5.217)had a higher risk of non-adherence of hepatitis B vaccine.Patients with the income level<5000-yuan(OR=0.490,95%CI:0.249-0.966)and receiving short-term hepatitis B vaccine(0-1-620/60μg)schedule(OR=0.388,95%CI:0.200-0.752)had a lower risk of non-adherence of hepatitis B vaccine.Interaction results showed that there were additive interactions or multiplicative interactions between age and income level,and between income level and hepatitis B vaccination schedule,and between the drop-out of previous methadone maintenance treatment and hepatitis B vaccination schedule.Conclusion The adherence of hepatitis B vaccine is suboptimal in patients receiving methadone maintenance treatment.Age,income level,the drop-out of previous methadone maintenance treatment and hepatitis B vaccination schedule are the influencing factors of the adherence of hepatitis B vaccine in patients receiving methadone maintenance treatment,and the interaction between the influencing factors increase the risk of non-adherence of hepatitis B vaccine.

关 键 词：美沙酮维持治疗 乙型肝炎疫苗 接种依从性 影响因素 交互作用 

分 类 号：R186[医药卫生—流行病学]