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目的探讨海洛因依赖者美沙酮维持治疗(MMT)前后肝肾功能的变化情况及其影响因素。方法对盐城市美沙酮门诊病人入组时及维持治疗1年后进行检测的血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿素(UREA)和肌酐(Cr)结果进行统计分析。结果 299例海洛因依赖者MMT前ALT、AST、UREA、Cr异常率分别为35.12%、31.44%、1.00%和0.67%,男性、HCV抗体阳性是MMT前ALT异常的危险因素,年龄、HCV抗体阳性是MMT前AST异常的危险因素。173例海洛因依赖者接受MMT 1年后ALT、AST的检测结果(t ALT=2.901,P=0.004;t AST=2.836,P=0.005)和异常率(ALT=4.504,P<0.05;AST=7.268,P<0.01)均显著下降,男性、低年龄段、HCV抗体阳性及入组时ALT异常是维持治疗后ALT异常的危险因素,HCV抗体阳性也是治疗后AST异常的危险因素。维持治疗前后肾功能无明显变化。结论海洛因依赖者肝功能损害者比例较高,美沙酮维持治疗可有效改善肝损害。
Objective To investigate the changes of liver and kidney function and its influencing factors before and after methadone maintenance treatment (MMT) in heroin addicts. Methods Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea (UREA) and creatinine (Cr) were measured in methadone outpatients in Yancheng city and after 1 year of maintenance treatment. Results of statistical analysis. Results The abnormal rates of ALT, AST, UREA and Cr in MMU of 299 heroin addicts before and after MMT were 35.12%, 31.44%, 1.00% and 0.67%, respectively. The positive rate of HCV antibody in males was the risk factor of ALT abnormality before MMT. Is a risk factor for AST abnormalities before MMT. 173 cases of heroin addicts received ALT and AST after 1 year of MMT (t ALT = 2.901, P = 0.004; t AST = 2.836, P = 0.005) and abnormalities (ALT = 4.504, , P <0.01). The masculine age, the low age group, the positive of HCV antibody and the ALT abnormality were the risk factors of abnormal ALT after maintenance therapy. The positive of HCV antibody was also the risk factor of AST abnormality after treatment. No significant change in renal function before and after treatment. Conclusion There is a high proportion of patients with heroin addicts with liver dysfunction. Methadone maintenance treatment can effectively improve liver damage.