摘要
目的调查社区美沙酮维持治疗（methadone maintenance treatment, MMT）者长期治疗情况及其影响因素。方法选择四川、云南、广西、贵州、浙江5个省（自治区）的8个MMT门诊作为研究现场。以2004年开始接受MMT治疗，且2010年6月随访时仍在参加MMT的539例治疗者作为研究对象。采用x。检验的方法对连续性治疗及非连续性治疗者在随访开始时的人口学特征、既往毒品滥用情况以及随访期间治疗情况等特征的分布情况进行比较。结果在539例研究对象中，110例（20．4％）属于连续性治疗者，429例（79．6％）属于非连续治疗者。84．1％（361／429）的非连续治疗者退出后重新入组次数为2～4次，15．9％（68／1429）退出后重新人组次数在5次以上。连续性治疗者及非连续性治疗者与家人朋友居住的比例分别为88．2％（97／110）、78．5％（337／429）；首次吸毒年龄在25岁以下的比例分别为61．8％（68／110）、71．3％（306／429）；居住在距离门诊5km范围内的比例分别为72．7％（80／110）、61．3％（263／429）；美沙酮尿检阳性率较低（1％～10％）的比例分别为67．3％（74／110）、38．2％（164／429）；差异均有统计学意义（P〈0．05）。连续性治疗者与非连续性治疗者在人组治疗时的性别、年龄、有无工作、与家人关系、毒品滥用时间、注射吸毒、共用针具、违法犯罪行为、与吸毒朋友交往次数以及参加治疗后的治疗剂量、是否有家人也接受MMT治疗等方面差异均无统计学意义（P〉0．05）。结论治疗期间偷吸毒品及居住地离门诊的距离等因素可能会对治疗者能否不问断地参加治疗造成影响。可通过MMT流动服务车、设立延伸服药点等措施尽可能提高治疗依从性。
Objective To describe the characteristics and factors associated with long-term retention for methadone maintenance treatment （MMT） patients. Methods This study was conducted in eight MMT clinics located in Sichuan, Yunnan, Guangxi, Guizhou and Zhejiang provinces. Five hundred and thirty-nine MMT patients who enrolled in MMT clinics in 2004 and retained in treatment by June 2010 were selected as study subjects. Chi-square tests were used to compare the demographics and drug abuse history at enrollment and treatment characteristics during the follow-up period between continuous treatment patients and discontinuous treatment patients. Results Of the 539 patients, 110 （ 20. 4% ） were continuous treatment patients whereas 429 （79. 6% ） were discontinuous treatment patients. Of these 429 discontinuous treatment patients, 84. 1% （361/429） had 2 -4 treatment episodes whereas 15.9% （68/429） had 5 or more episodes during follow-up period. When continuous treatment patients were compared with discontinuous treatment patients, living with family members or friends （88.2% （97/110）, 78.5% （337/429））, age of first drug use under 25 （61.8% （68/110） , 71.3% （306/429）） , low urine morphine positive test results （ 67.3% （74/110） , 38.2% （164/429） ） and living within 5 kilometers of the MMT clinic （72. 7% （80/ 110 ）, 61.3 % （263/429） ） were positively associated with higher possibility of continuous treat retention （P 〈0. 05）. Demographics and drug abuse characteristics at enrollment, including gender, age, employment status, family relationship, injection, needle sharing, criminal behavior, contacts with drug users, MMT daily dosage and family members receiving MMT were not significantly associated with treatment retention （ P 〉 0.05 ） . Conclusion Illicit drug use during the treatment and longer distance travelling to MMT clinic might have negative impact on patients＇ continuous treatment retention. Mobile MMT vehicles and expanded MMT service sites could be introduced to improve compliance of treatment retention of MMT patients.
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2012年第11期995-998,共4页
Chinese Journal of Preventive Medicine
基金
中央补助地方公共卫生专项经费艾滋病防治项目
美国国立卫生研究院福格蒂国际中心中国艾滋病预防多学科培训项目（China-ICOHRTA,5U2RTW006918-08）
关键词
获得性免疫缺陷综合征
美沙酮
治疗
随访研究
Acquired immunodefieiency syndrome
Methadone
Therapy
Follow-up studies
