四川省凉山彝族自治州静脉吸毒人群死亡率及死因的前瞻性队列研究

目的　了解四川省凉山彝族自治州静脉吸毒人群死亡率及死因。方法　于 2002 年 11月筛选和招募静脉吸毒人群队列376人,调查其社会人口学和吸毒行为特征。队列随访时间为 1 年,计算静脉吸毒人群的死亡率和死因构成,对死亡危险因素采用单因素和多因素 Cox回归分析。结果队列随访1年中,死亡28人,死亡率为77.32/1000 人年(95%CI:48.68~105.95),标准化死亡比为47.62(95%CI:31.63~68.71)。主要死因是吸毒过量,占全部死因的64.3%(18/28)。多因素Cox回归分析未发现与死亡(包括全部死因)有统计学关联的变量;但发现社会人口学因素中的单身和吸毒行为中的吸毒年限(≥9年)两个变量与吸毒过量死亡有统计学关联(P<0.05),其危险比分别是4.51(95%CI:1.03~19.67)和2.77(95%CI:1.10~7.00)。结论　吸毒过量致死是凉山州静脉吸毒者的主要死亡原因,需要进一步研究与吸毒过量死亡有关的因素以及干预对策。

An 12year prospective cohort study on mortality of injecting drug users

OBJECTIVE: To study the mortality among injecting drug users (IDUs) from an IDUs cohort in Liangshan of Sichuan province. METHODS: In November 2002, 376 injecting drug users were recruited and followed up for 1 year as part of a prospective cohort study. Socio-demographics and risk behaviors on drug use were recorded. After one year, the mortality rate was estimated and risk factors for mortality were analyzed using Cox regression. RESULTS: Out of the original cohort of 376 participants, there were 28 reported and confirmed deaths during the one year follow-up period. The mortality rate of the cohort was 77.32 per 1000 person-years (95% CI: 48.68 - 105.95) with the standardized mortality ratio (SMR) as 47.62 (95% CI: 31.63 - 68.71). Out of the 28 deaths, 64.3% (18/28) caused by overdoses of drug. No variables were found to be associated with death of all causes, but being un-married and >or= 9 year history of injecting drugs were found to be associated with overdose-related mortality in the final model of Cox regression. The hazard ratios were 4.51 (95% CI: 1.03 - 19.67) and 2.77 (95% CI: 1.10 - 7.00) respectively. CONCLUSION: Overdose served the most frequent cause of deaths in Liangshan of Sichuan province. Future studies should be conducted to focus on mortality and risk factors associated with mortality among IDUs to provide targeted interventions in reducing unnatural mortality.