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目的了解不同类型美沙酮维持治疗门诊的服药人员海洛因偷吸情况及其影响因素。方法对云南省德宏州5个县(市)的5个美沙酮维持治疗门诊(MMT)和1 7个拓展服药点中,462名美沙酮维持治疗者进行10个月的随访调查,分析MMT门诊和拓展服药点服药人员的基本人口学信息、治疗前吸毒行为、生活质量、尿吗啡检测结果;应用广义估计方程(GEE),对影响新入组研究对象尿吗啡检测结果阳性的因素进行分析。结果 462例研究对象中,223例来自拓展服药点,239例来自MMT门诊;男性451例(97.6%),中位平均年龄为(37.8±9.1)岁,汉族占40.7%(188例)。拓展服药点研究对象随治疗时间延长,尿吗啡阳性率下降(χ~2=43.352,P<0.001)。多因素分析结果显示,拓展服药点的、治疗前1个月有注射吸毒行为的、治疗后自我感觉与家人的关系差的研究对象,其尿吗啡检测阳性的风险,分别高于MMT门诊者、无注射吸毒行为者、自我感觉与家人的关系一般者。结论拓展服药点服药人员随访期间尿吗啡阳性率随服药时间延长有下降趋势。但拓展服药点的研究对象尿吗啡检测阳性的风险高于MMT门诊,应加强家庭和社区的监督与配合作用。
Objective To understand the situation of heroin inhalation and its influencing factors in different types of methadone maintenance treatment outpatients. Methods A total of 462 methadone maintenance therapists in 5 methadone maintenance treatment clinics (MMT) and 17 outreach stations in 5 counties (cities) in Dehong Prefecture of Yunnan Province were investigated for 10 months. The MMT clinic and The basic demographic information, drug abuse before treatment, quality of life and urinary morphine test results were expanded. The generalized estimating equation (GEE) was used to analyze the factors influencing the positive results of urinalorphine in the newly enrolled subjects. Results Of the 462 subjects, 223 were from outreach medication centers and 239 were from MMT clinics; 451 were male (97.6%) with a mean median age of (37.8 ± 9.1) years and 40.7% (188) of Han Chinese. With the extension of treatment time, the positive rate of urinary morphine decreased (χ ~ 2 = 43.352, P <0.001). The results of multivariate analysis showed that the subjects who developed medication points and had drug abuse behaviors one month prior to treatment had poor relationship with their family members after treatment, and the risk of positive urine morphine test was higher than that of MMT clinic patients, No drug addicts, those who feel the same with their families. Conclusions The positive rate of urinary morphine during the follow-up period of patients taking extended-dose medication is declining with the extension of time. However, the study of developing drug-taking point of urine test positive for morphine than the MMT clinic, should strengthen the family and community supervision and coordination.