广西壮族自治区全州县海洛因成瘾者美沙酮治疗依从性及影响因素分析

目的：了解广西壮族自治区全州县海洛因成瘾者美沙酮维持治疗（MMT）的依从性并探讨其影响因素，为提高MMT的效果、提出地区性综合防治措施提供一定的科学依据。方法选择2009年5月至2012年5月在该县美沙酮门诊进行维持治疗的194例患者为研究对象，回顾性分析患者的人口学特征、治疗脱失情况、药物滥用史和社会支持情况，采用Logistic回归方法分析MMT依从性的影响因素。结果194例患者中MMT保持者135例（69.59%），MMT脱失者59例（30.41%）。多因素Logistic回归分析结果显示，文化程度低、无固定职业、离异、注射吸毒和有药物滥用史是MMT依从性的危险因素，家人支持是MMT依从性的保护因素（OR=1.725、1.866、1.392、1.746、1.760、1.250、0.881，P＜0.05）。结论及早识别MMT依从性差的患者，加强门诊医务人员的沟通和心理干预技巧，有效建立患者的社会支持网络，开展人性化的美沙酮门诊服务模式，是提高MMT依从性、防治毒品滋生违法犯罪以及艾滋病感染和蔓延等社会问题的有效途径。

Anlaysis of the treatment compliance of methadone maintenance treatment for heroin addicts and the influencing fac tors

Objective To understand the compliance of methadone maintenance treatment （MMT） for heroin addicts in Quanzhou county,so as to provide scientific basis for promoting the effect of MMT and proposing comprehensive preventive mea-sures. Methods The patients with MMT,who were with methadone for maintenance treatment in the county from May 2009 to May 2012,were selected as study objects. Retrospective analysis was conducted on the demographic characteristics ,treatment withdraw,history of substance abuse and society support of the patients ,and Logistic regression was taken to analyze the influenc-ing factors of MMT compliance. Results A total of 194 patients were taken in this study ,135 cases of which were MMT retainer accounting for 69.59%and 59 were MMT withdrawers （30.41%）. The results of Logistic regression showed that low education de-gree,irregular occupation,divorcement,injection drug use and history of substance abuse were risk factors of MMT compliance , and family support was the protective factor of MMT compliance（OR=1.725、1.866、1.392、1.746、1.760、1.250、0.881,P〈0.05）. Con-clusion The effective methods to increase MMT compliance,prevent drug crime problem,HIV infection and spread are early di-agnosis of patients with poor compliance of MMT ,enhancement of the communication and psychological intervention skills of clin-ic staff,effective establishment of social support network and development of humanized clinic service model.