美沙酮替代治疗降低吸毒者肺部并发症效果的研究

The study of therapeutic effect of Methadone replacement therapy on pulmonary complications in drug addicts

目的探讨用美沙酮替代治疗是否有效降低吸毒者肺部并发症罹患率,为美沙酮替代治疗对吸毒者并发症的影响提供更多的科学依据。方法走访美沙酮替代治疗门诊和市戒毒所,调查、筛选和确定样本量,选取90例坚持用美沙酮替代治疗吸毒者(病例组)和90例不用美沙酮替代治疗吸毒者(对照组)进行摄胸片检查,对两组胸片X射线影像改变特征进行统计学分析。结果两组人员性别和调查前吸毒时间差异无统计学意义(P>0.05);在研究中,病例组的治疗脱失率和对照组的跟踪脱落率均较高,分别为36.67%和33.33%;病例组X射线胸片检查异常6例,阳性率10.53%,主要病变为双肺纹理增粗4例,肺结核和肺感染各1例,X射线特征单一;对照组X射线胸片检查异常26例,阳性率43.33%,主要病变是肺结核病8例,双肺纹理增粗7例,并见胸积液4例、气胸3例和心影改变2例等,X射线特征复杂多样;两组胸片阳性率比较差异有统计学意义(P<0.05)。结论坚持用美沙酮替代治疗可以有效降低吸毒者肺部并发症的罹患率。

Objective To explore the effectiveness of methadone replacement therapy in reducing the attack rate of pulmonary complications in drug addicts, and provide more scientific basis for Methadone replacement therapy on complications in drug addicts. Methods After visiting the Methadone replacement therapy clinics and drug rehabilitation center in our city, we have investigated, screened and determined the sample size. 90 drug addicts who persist in Methadone replacement therapy were selected for the case group and 90 drug addicts without Methadone replacement therapy for the control group. Chest radiographs of two groups were taken and analyzed for the changes of imaging characteristics. Results Two groups had no statistical significances （P〉0.05） on gender and drug using time prior to the survey. In the study, two groups both had high treatment dropout rate （36.67%）, and tracking off rate （33.33%）. 6 people in the case group were discovered abnormalities in chest X-ray（positive rate： 10.53%）. The main lesions were bi- lung markings thickening （4 cases）, tuberculosis（ 1 case） and lung infection（ 1 case）, with simple X-ray characteristics. 26 people in the control group were discovered abnormalities in chest X-ray（positive rate： 43.33%）. The main lesions were tuberculosis （8 cases）, bi-lung markings thickening（7 cases）, pleural effusion （4 cases）, pneumothorax （3 cases） and the heart shadow＇s change （2 cases）, with complex X-ray characteristics. The difference between two groups in chest X-ray＇s positive rate had statistical significance （P〈0.05）. Conclusion Persistent Methadone replacement therapy can effectively reduce the incidence of pulmonary complications in drug addicts.