广东省首批社区美沙酮维持治疗维持时间及其影响因素

陈昂; 夏英华; 陈雯; 凌莉; 谭文康; 郑荣加

Abstract

陈昂,夏英华,陈雯,凌莉,谭文康,郑荣加.广东省首批社区美沙酮维持治疗维持时间及其影响因素[J].Chinese journal of Epidemiology,2009,30(12):1230-1233

广东省首批社区美沙酮维持治疗维持时间及其影响因素

Predictors of retention related factors at the initial methadone maintenance treatment clinics in Guangdong province

Received:April 07, 2009

DOI：

KeyWord: 美沙酮维持治疗维持时间生存分析

English Key Word: Methadone maintenance treatment Retention Survival analysis

FundProject:广东省艾滋病防治项目基金(2003101)

Author Name	Affiliation	E-mail
CHEN Ang	中山大学公共卫生学院医学统计与流行病学系, 广州 510080	lingli@mail.sysu.edu.cn
XIA Ying-hua	中山大学公共卫生学院医学统计与流行病学系, 广州 510080
CHEN Wen	中山大学公共卫生学院医学统计与流行病学系, 广州 510080
LING Li	中山大学公共卫生学院医学统计与流行病学系, 广州 510080
TAN Wen-kang	广东省阳东县大沟卫生院
ZHENG Rong-jia	台山市太和卫生院

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Abstract:

目的探讨广东省首批开展的两个社区美沙酮维持治疗试点治疗对象的维持时间及其影响闪素,为预防脱失提供参考依据.方法对两试点纳入的治疗对象在入组时进行基线调查,并在治疗期间随访.采用生存分析方法对治疗对象的维持时间及其影响因素进行分析.结果共纳入研究对象509例,经Kaplan-Meier法估计,维持时间的中位数为108 d(95%CI:74～142 d).1、3、6和12个月的维持率分别为75.9%、52.7%、41.6%和30.1%.经多因素Cox比例风险模型分析发现,入组时HIV感染与否(HR=1.241,P=0.047)、日平均剂量(HR=0.633,P=0.004)和治疗过程中偷吸(HR=5.345,P=0.000)是维持时间的影响因素.结论广东省首批社区美沙酮维持治疗试点维持率较低.入组时HIV检测为阴性、治疗期间有偷吸行为以及日平均剂量较低者容易脱失,应适当提高服药剂量和延长维持时间.

English Abstract:

Objective To identify predictors of treatment retention problems at the two initial methadone maintenance treatment(MMT)clinics in Guangdong province,and to provide reference in reducing the rate of drop-outs.Methods All of the patients were investigated at baseline and followed during the treatment period.Kaplan-Meier method on Survival Analysis was used to analyze retention related factors and predictors.Results 509 subjects were recruited in this study with median of retention time as 108 days(95%CI:74-142 days).The retention rate at 1-,3-,6-,12-months were 75.9%,52.7%,41.6%,30.1%,respectively.Data from Multivariate Cox Proportional Hazard Model analysis showed predictors of retention would involve factors as HIV infection state at baseline(HR=1.241,P=0.047),daily methadone dose(HR=0.633,P=0.004)and secretly using drugs during treatment period(HR=5.345,P=0.000).Conclusion The retention rates at the two initial MMT clinics in Guangdong province were low.Patients who were HIV negative at baseline but still secretly using heroine during treatment or accepted low daily average dosage of methadone,had the tendency to drop out.The results implied that retention time could be prolonged by increasing daily methadone dosage.

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