稽延性戒断症状对纳曲酮服药依从性的影响

目的：探讨稽延性症状对纳曲酮依从性的影响和二者的相关性。方法：采用回顾性流行病学调查的方法，在广东、北京、浙江等地搜集到531例服用纳曲酮的海洛因依赖者，调查有关人口学和社会学信息、药物滥用史、纳曲酮使用和稽延性戒断症状的情况。分析纳曲酮短期组（服用时间≤4周）、中期组（服用时间〉4周且〈24周）和长期组（服用时间≥24周）脱毒后的稽延性戒断症状评分和服用纳曲酮时间的关系。结果：纳曲酮短期组、中期组和长期组患者脱毒后的稽延性戒断症状评分总分和睡眠障碍、焦虑情绪和躯体症状三类中的7个分项得分经F检验，P〈0.05。经进一步的组间两两t检验，在中期组和短期组之间，总分和易醒、早醒、全身无力、手脚不舒服4个分项得分P〈0．05。在长期组和短期组之间，总分和易醒、入睡困难、全身无力、烦躁不安4个分项得分P〈0.05。在长期组和中期组之间，总分和各分项得分P〉0．05。稽延性戒断症状与纳曲酮的依从性呈负相关，在短期-中期-长期组相关性检验中，稽延性戒断症状的总分和4个分项得分（入睡困难、易醒、烦躁不安和全身无力）P〈0．05。在短期-中期组相关性检验中，稽延性戒断症状的总分和6个分项得分（入睡困难、易醒、早醒、全身无力、全身难受和四肢不适）P〈0．05。结论：稽延性戒断症状是影响纳曲酮早期服药依从性的重要因素，对长期依从性没有影响。如果在服用纳曲酮早期，稽延性戒断症状得到较好控制，纳曲酮的依从性和防复吸的疗效会提高。

The impact of protracted withdrawal symptoms on the compliance of naltrexone

Objective： To discuss the impact of protracted withdrawal symptoms （PWS） on the compliance of naltrexone and the relativity of these. Methods： Evaluation on the relativity of PWS and compliance ofnaltrexone for heroin addicts ,which are taking or have taken naltrexone, by multi-center retrospect epidemiological survey. Depending on the time of naltrexone maintenance, all these heroin addicts are divided into three groups, which are short-term group （≤4 weeks）, long-term group （≥24 weeks） and medium group （〉4 weeks and 〈 4 weeks）.The scale of PWS and information about naltrexone maintenance are the main data. Results： By F-test, there are significant differences in the sum and totally 7 items of the scale, which are parts of three groups, disorder of sleep,somatic symptoms and anxiety respectively （P〈0.05）. Based on the further P-test among groups, there are significant differences in the sum and 4 items of PWS scale, including easy to wake up, early morning awakening, systemic fatigue and suffering, between short-term and medium group （P〈0.05）. And the sum and 4 items between short-term and long-term group, including easy to wake up, insomnia, systemic fatigue and dysphoria （P〈0.05）. But there is no difference between medium and long-term group. The status of PWS is a negative factor on compliance ofnaltrexone with low relativity. By short-medium-long-term relativity analysis, there are significant relativity on the sum and 4 items （insomnia, easy to wake up, dysphoria and systemic fatigue） （P〈0.05）. By short-medium-term relativity analysis, there are significant relativity on the sum and 6 items of PWS scale （insomnia, easy to wake up, early morning awakening, systemic fatigue and suffering and dysphoria） （P〈0.05）. Conclusion： The status of PWS is a negative factor towards the compliance of naltrexone and plays a key role during the early period of naltrexone maintenance therapy. With PWS be well treated, the compliance of naltrexone will be e