| 姚添,冯丹,潘明虎,程雁鹏,李春霞,王君,冯永亮,石璟,苏通,陈卿,石珊,王素萍.美沙酮维持治疗者服药剂量不足及吗啡尿检阳性与脱失的关系[J].Chinese journal of Epidemiology,2017,38(5):646-650 |
| 美沙酮维持治疗者服药剂量不足及吗啡尿检阳性与脱失的关系 |
| Correlation between insufficient methadone dosage and morphine positive urine on drop out of treatment in patients with access to methadone maintenance treatment |
| Received:October 19, 2017 |
| DOI：10.3760/cma.j.issn.0254-6450.2017.05.018 |
| KeyWord: 美沙酮维持治疗 脱失 剂量 吗啡尿检 交互作用 |
| English Key Word: Methadone maintenance treatment Drop out Morphine urine Dosage Interaction |
| FundProject:国家科技重大专项（2012ZX10002001-003-004）；山西省回国留学人员科研资助（2013-056） |
| Author Name | Affiliation | E-mail | | Yao Tian | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Feng Dan | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Pan Minghu | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Cheng Yanpeng | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Li Chunxia | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Wang Jun | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Feng Yongliang | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Shi Jing | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Su Tong | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Chen Qing | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | | | Shi Shan | Nanning Red Cross Hospital, Nanning 530012, China | | | Wang Suping | Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China | spwang88@163.com |
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| Abstract: |
| 目的 了解美沙酮维持治疗（MMT）门诊治疗患者的脱失情况，探讨美沙酮剂量<100 mg/d和吗啡尿检阳性与脱失的关系及交互作用。方法 2014年9-11月对广西壮族自治区3个MMT门诊1 031例患者开展问卷调查，收集一般人口学特征、HIV感染、既往吸毒及吗啡尿检等信息。通过单因素和多因素logistic回归分析脱失的相关因素，通过交互作用分析探讨美沙酮剂量<100 mg/d与吗啡尿检阳性与脱失的关系。结果 1 031例MMT患者的脱失率为40.6%（419/1 031），尿检阳性者和美沙酮剂量<100 mg/d者的脱失率分别是57.6%（99/172）和37.4%（347/929），高于尿检阴性者（42.3%，363/859）和美沙酮剂量≥100 mg/d者的脱失率（26.5%，27/102）。控制混杂因素后，美沙酮剂量<100 mg/d者比剂量≥100 mg/d者更易于发生脱失（OR=3.05，95%CI：1.84~5.06），尿检阳性者比阴性者更易于发生脱失（OR=2.25，95%CI：1.59~3.19）。美沙酮剂量<100 mg/d和吗啡尿检阳性存在相加（RERI=256.46，AP=0.87，S=8.05）和相乘（OR=2.45，95%CI：1.71~3.49）交互作用且方向一致。结论 MMT中，美沙酮剂量<100 mg/d及吗啡尿检阳性与脱失呈明显相关。 |
| English Abstract: |
| Objective To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region. Methods Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi. Results The study included 1 031 participants, 40.6% of them (419/1 031) had stopped treatment. The drop out rates in urine morphine positive group and methadone dosage <100 mg/d group were 57.6% (99/172) and 37.4% (347/929) respectively, higher than those in urine morphine negative group and methadone dosage ≥100 mg/d group (42.3%, 363/859, and 26.5%, 27/102). Orderly logistic regression analysis results showed that after adjusted factors, such as gender, age, marital status, ethnic group, patients who received a dosage less than 100 mg/day (OR=3.05, 95%CI: 1.84-5.06) and had morphine positive urine (OR=2.25, 95%CI: 1.59-3.19) were more likely to drop out of the treatment. Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction (RERI=256.46, AP=0.87, S= 8.05) and multiplication interaction (OR=2.45, 95%CI: 1.71-3.49). Conclusion Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment. |
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