成都市成华区2007-2014年美沙酮门诊维持治疗效果评价

Evaluating the effect of Methadone Maintenance Therapy on drug users in Chenghua District of Chengdu from 2007 to 2014

目的:了解四川省成都市成华区美沙酮门诊维持治疗效果并探讨其影响因素。方法:采用回顾性队列研究,以2007年8月31日~2014年12月31日在成华区美沙酮维持治疗门诊登记服药的吸毒人员为研究对象,对研究对象的一般情况、效果评价指标等进行描述性分析,运用Cox比例风险回归模型分析影响因素。结果:最终纳入1875名研究对象,受治者首次吸毒平均年龄为(28.78±7.83)岁,平均维持时间(37.42±26.07)个月,到研究截止时共815人退出治疗;多因素分析结果显示,吸毒年限为5年以下、MMT日均维持剂量60ml以上是受治者维持治疗的保护因素,而未婚是危险因素;通过对受治者随访情况的分析,其社会功能指标得到显著改善。结论:成华区美沙酮维持治疗门诊在减少受治者毒品使用的同时降低了感染艾滋病的风险,有助于受治者家庭与社会功能的恢复,应适当提高维持治疗剂量,辅以心理干预,以进一步减少偷吸、提高治疗效果。

Objective To study the effect and influencing factors of Methadone Maintenance Therapy （MMT） on drug users in Chenghua District of Chengdu. Methods A retrospective cohort study was conducted on drug users enrolled from MMT clinics in Chenghua District from August 31,2007 to December 31,2014. Descriptive method was used to analyze its demographic charac- teristics, drug-using behaviors and effect indices. Factors affecting MMT adherence were analyzed by Cox proportional hazards re- gression model. Results The included 1875 cases of drug users had average initial abuse age of 28.78± 7.83 years old, and medi- an duration of 37.42 ± 26.07 months. Multiple-factor analysis showed that drug abuse duration less than 5years, and daily dosage of MMT higher than 60 ml/day were protective factors for the retention, but unmarried status was the risk factor. Social function indices of drug users were significantly improved after the treatment. Conclusion Methadone maintenance treatment can reduce drug-abusing behaviors and risk of HIV infection, and restore their social function and family relationship. It is suggested to in- crease dairy average dosage and psychological intervention for reducing the relapse and improving the compliance rate.