Abstract
曹晓斌,殷文渊,庞琳,张从斌,徐金水,肖永康,王常合,罗巍,张波,张瑞敏,李志军,柔克明,吴尊友.中国九城市1301名社区美沙酮维持治疗门诊患者偷吸海洛因及影响因素分析[J].Chinese journal of Epidemiology,2010,31(3):269-272
中国九城市1301名社区美沙酮维持治疗门诊患者偷吸海洛因及影响因素分析
Risk factors which were associated with heroin use during the methadone maintenancetreatment among 1301 patients in 9 cities of China
Received:September 15, 2009  
DOI:
KeyWord: 美沙酮维持治疗  海洛因  影响因素
English Key Word: Methadone maintenance treatment  Heroin use  Risk factors
FundProject:中央补助地方公共卫生专项经费艾滋病防治项目;美国疾病预防控制中心伞球艾滋病项目(USCDCGAP6.3.1 C)
Author NameAffiliationE-mail
CAO Xiao-bin National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China  
YIN Wen-yuan National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China  
PANG Lin National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China  
ZHANG Cong-bin Department of Social Service, Yunnan Institute for Drug Abuse  
XU Jin-shui Department of AIDS Control and Prevention, Jiangsu Center for Disease Control and Prevention  
XIAO Yong-kang Department of AIDS Control and Prevention, Anhui Center for Disease Control and Prevention  
WANG Chang-he National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China  
LUO Wei National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China  
ZHANG Bo Department of Social Service, Yunnan Institute for Drug Abuse  
ZHANG Rui-min Department of Social Service, Yunnan Institute for Drug Abuse  
LI Zhi-jun Global AIDS Program, US Center for Disease Control and Prevention  
ROU Ke-ming National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China  
WU Zun-you National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China wuzy@263.net 
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Abstract:
      目的 了解社区美沙酮维持治疗患者治疗期间偷吸海洛因的情况及其影响因素.方法 在江苏、安徽、云南3省9个城市社区美沙酮维持治疗门诊中抽取1301名符合条件的患者进行问卷调查与随机尿吗啡定性检测.收集一般人口学、艾滋病/毒品滥用相关高危行为、参加美沙酮维持治疗情况、抑郁与焦虑及偷吸海洛因等信息.结果 1301名调查对象中男性居多(76.2%),年龄(34.6±6.5)岁,受教育程度以初中及以下为主(71.7%).平均维持治疗剂量(48.1±29.4)mg/d,目前治疗剂量自我满意度平均得分为8.6,尿吗啡检测阳性率为27.7%.有抑郁和焦虑症状者比例分别为38.3%和18.4%,抑郁合并焦虑症状的比例为14.2%.婚姻状况、治疗时间的长短、目前治疗剂量自我满意度及是否曾退出治疗对偷吸海洛因影响的差异有统计学意义,而性别、教育程度及治疗剂量对偷吸海洛因的影响差异无统计学意义.不同省份间影响偷吸海洛因的因素有所不同,但对当前剂量自我满意度是共同的影响因素.结论 提高门诊服务质量及服药依从性、延长参加治疗的时间、提高患者对治疗剂量的满意度及避免脱失对减少治疗期间偷吸海洛因有重要意义.
English Abstract:
      Objective To determine the proportion of heroin use among patients who were involved in community-based methadone maintenance treatment (MMT) program and to identify the risk factors associated with heroin use. Methods This study was conducted in 9 MMT clinics within 3 provinces. Thirteen hundred and one patients who met the study criteria were selected from each of the five groups with different dosages of methadone users. An administrative questionnaire was applied to explore the demographics,drug abuse-related behaviors and MMT services received by the clients,etc. The prevalence of depression and anxiety among the clients were also collected by SAS and SDS. Urine samples were collected as a biological marker to indicate if heroin had been used. /b>Results Of the 1301 patients,76.2% were males. The mean age was (34.6±6.5) years while 71.7% had an education level of primary school or below. The average daily dosage of methadone was (48.1±29.4) mg and self-satisfied evaluation score on treatment was 8.6. On average,27.7% urine samples showed positive opiate evidence. Marital status,employment status,treatment retention,self-satisfied evaluation score on dosage and dropout history were found to be significantly associatedwith heroin use,while gender,education level and dosage had no significant association with heroin use. It seemed that risk factors that associated with heroin use were different from areas to areas. Conclusion High quality MMT clinic services,high self-satisfied score,longer treatment retention and low dropout rate seemed to have the effects of reducing the risk of ongoing heroin abuse under the methadone maintenance treatment program.
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