酒精依赖症患者治疗后复饮的相关风险因素分析

Analysis of the risk factors of recurrence in patients with alcohol dependence after treatment

目的探讨酒精依赖症(ADS)患者治疗后复饮的相关风险因素并分析其临床意义。方法选取2018年1月—2019年6月青岛市精神卫生中心戒酒科收治的ADS患者207例为研究对象,跟踪随访1年调查复饮情况。根据随访期间患者复饮情况将103例复饮患者设为复饮组,未复饮患者97例设为对照组,比较两组临床资料差异及WHOQOL-BREF评分差异。将差异有统计学意义因素纳入多因素logistic回归模型,筛选有显著影响的风险因素。结果复饮组中日摄入量、饮酒时间>15年占比及SADQ-C评分>30分占比明显高于对照组;复饮组年龄及受教育程度明显低于对照组;复饮组WHOQOL-BREF评分社会关系领域及生理领域评分均明显高于对照组,上述差异均有统计学意义(P<0.05)。复饮组logistic多因素回归分析显示,年龄小(OR=13.447,95%CI:1.301-38.090,P=0.002)、教育程度低(OR=4.958,95%CI:2.032-33.988,P=0.001)、社会关系领域分值较低(OR=4.844,95%CI:1.053-9.674,P=0.029)、生理领域生存质量评分较低(OR=8.626,95%CI:1.400-15.540,P=0.005)是酒精依赖复发的危险因素;饮酒时间短(OR=0.202,95%CI:0.189-0.965,P<0.001)、日摄入量少(OR=0.337,95%CI:0.212-13.707,P<0.031)、SADQ-C评分低(OR=0.394,95%CI:0.123-9.942,P<0.005)是酒精依赖复发的保护因素。结论年龄小、教育程度低、生理领域及社会关系领域生存质量低、饮酒时间长、饮酒量大、SADQ-C评分高的ADS患者复饮的可能性较大,临床上应给予重视。

Objective To investigate the risk factors of recurrence after treatment in patients with alcohol dependence and to analyze its clinical significance.Methods Totally 207 patients with alcohol dependence admitted to the department of alcohol addiction in our hospital from January 2018 to June 2019 were selected.The patients were followed up for 1 year after discharge to investigate the situation of recurrence.During the follow-up period,103 cases with recurrence were included as the recurrence group,and 97 cases without recurrence were included as the control group.The differences of general demographic and clinical data and WHOQOL-BREF scores were compared between the two groups.Logistic regression analysis was used to analyze the correlation between the factors with statistical difference and recurrence.Results The daily intake,proportion of duration of drinking>15 years and SADQ-C score>30 points in the recurrence group were significantly higher than those in the control group.The age and education level of the observation group were significantly lower than those of the control group.The WHOQOL-BREF scores of the recurrence group in social relations,and physiology were significantly higher than those of the control group,and the above differences were statistically significant(P<0.05).In logistic regression analysis,young age(OR=13.447,95%CI:1.301-38.090,P=0.002),low education level(OR=4.958,95%CI:2.032-33.988,P=0.001),low scores of social relationship(OR=4.844,95%CI:1.053-9.674,P=0.029)and physiology(OR=8.626,95%CI:1.400-15.540,P=0.005)in SADQ-C were the risk factors for recurrence of alcohol dependence,and short drinking periods(OR=0.202,95%CI:0.189-0.965,P<0.001),low daily intake(OR=0.337,95%CI:0.212-13.707,P<0.031)and low SADQ-C score(OR=0.394,95%CI:0.123-9.942,P<0.005)were the protective factors for recurrence of alcohol dependence.Conclusion Alcohol dependence patients with young age,low education level,low quality of life in physiological,social fields,long drinking periods,high daily intake and high SADQ-C score are more likely to recurrence,and more attention should be paid in clinical practice.