林永祯 艾强 杜展鹏

【摘要】 目的：探討同伴推动社区干预（PDI）美沙酮药物维持治疗（MMT）剂量的影响因素。方法：回顾性分析笔者所在医院2017年1-12月收治的行同伴推动社区干预下美沙酮药物维持治疗的99例阿片类物质成瘾患者的临床资料，比较PDI 30 d与PDI 90 d时患者基本情况，统计PDI 90 d时患者MMT剂量及相关影响因素。结果：干预90 d时患者脱失15例，多于干预30 d时的5例，差异有统计学意义（P=0.018）。干预30 d时与干预90 d时MMT低剂量人数、高剂量人数及美沙酮平均剂量比较差异均无统计学意义（P>0.05）。干预90 d时可见患者MMT维持剂量从20～120 mg，其中分布最多的为50 mg和60 mg，分别为14例和15例。分析不同剂量组患者相关资料之间的差异，结果显示受教育水平低及吸毒年限≥5年是影响患者维持治疗剂量的因素，差异均有统计学意义（P<0.05），性别、年龄、工作、婚姻及吸毒方式对维持治疗剂量的影响不明显，差异无统计学意义（P>0.05）。结论：受教育水平低及吸毒年限≥5年是导致阿片类物质成瘾者经PDI后行MMT需高维持剂量的影响因素。

【关键词】 同伴推动社区干预 美沙酮药物维持治疗 维持剂量 影响因素

doi：10.14033/j.cnki.cfmr.2020.13.062 文献标识码 B 文章编号 1674-6805（2020）13-0-03

Analysis of Influencing Factors of Peer-driven Community Intervention on Maintenance Dose of Methadone/LIN Yongzhen， AI Qiang， DU Zhanpeng. //Chinese and Foreign Medical Research， 2020， 18（13）： -151

[Abstract] Objective： To explore the influencing factors of peer-driven community intervention （PDI） on maintenance dose of Methadone （MMT）. Method： The clinical data of 99 opioid addiction patients receiving MMT treatment under PDI in our hospital from January to December 2017 were retrospectively analyzed. The basic conditions of patients receiving PDI intervention for 30 days and PDI intervention for 90 days were compared， the MMT dose and related factors after 90 days of PDI were statisticsed. Result： There were 15 cases of loss at 90 days， more than 5 cases at 30 days， the difference was statistically significant （P=0.018）. There was no statistically significant difference between the low-dose and high-dose MMT population and the average methadone dose at 30 days and 90 days of intervention （P>0.05）. At 90 days of intervention， the MMT maintenance dose of patients varied from 20 mg to 120 mg， with the largest distribution of 50 mg and 60 mg， 14 and 15 patients respectively. Difference between different dose groups related data were analyzed， the result showed that low education level and longer than 5 years of drug use were the factors influencing patients maintenance treatment dose， the differences were statistically significant （P<0.05）. Effects of sex， age， work， marriage and drug use patterns on maintaining the dose of treatment were not significant， there were no statistically significant differences （P>0.05）. Conclusion： Low education level and longer than 5 years of drug use are factors that led to high maintenance dose of MMT for opioid addicts after PDI intervention.

[Key words] Peer-driven community intervention Methadone maintenance therapy Maintenance dose Impact factor

First-authors address： Longfeng Street Community Health Service Centre of Haizhu District in Guangzhou City， Guangzhou 510250， China

美沙酮维持治疗（methadone maintenance treatment，MMT）是目前针对海洛因等阿片类毒品成瘾患者采取的一种较为有效的维持或替代治疗的方式，以减少由于滥用阿片类物质成瘾引起的疾病和相关违法犯罪，降低死亡率，并促进其家庭和社会功能的康复[1-2]。但是临床证据显示，患者行MMT的医疗依从性较差，脱失率较高。同伴推动社区干预（peer driven intervention，PDI）是指充分发挥同伴在宣传、转介、角色示范等方面的作用，在项目实施过程中对同伴、转介患者和工作人员采取激励措施，充分调动积极性，不断扩大美沙酮维持治疗覆盖面，提高患者治疗依从性的方法[3-4]。在P……