广州市部分社区美沙酮维持治疗点患者脱失影响因素分析

目的探讨广州市美沙酮维持治疗（MMT）门诊患者脱失的影响因素。方法将2008年9月30日至2010年10月31日期间在广州市天河、海珠及白云区等3个MMT治疗点接受治疗的患者，根据脱失与否分为脱失组和维持组，比较2组患者在社会人口学特征、毒品滥用情况、家庭及社会关系等方面的差别，采用非条件logistic回归分析方法分析影响患者脱失的因素。结果共调查患者1021例，其中脱失组218例，维持组803倒；男性933例，女性88例；2组病例首次吸毒年龄分别为23．11与24．80岁；平均吸毒花费分别为191．09及154．77元；过去1个月平均注射吸毒次数分别为105．24及106．40次；多因素logistic逐步回归分析结果显示：过去1个月与吸毒朋友交往次数的多少（OR=1．524）与首次吸毒年龄的大小（OR=0．773）是影响广州市天河区等3个MMT门诊患者脱失的主要因素。结论过去1个月与吸毒朋友交往次数越多、首次吸毒年龄越小的患者越容易脱失治疗，应针对影响患者脱失的因素采取多种形式的干预手段，提高治疗维持率。

Factors associated with patients dropping out of the community-based methadone maintenance treatment in three clinics in Guangzhou

Objective To identify factors associated with patients dropping out of community-based methadone maintenance treatment （MMT） in Guangzhou City. Methods MMT patients in three MMT clinics of Tianhe, Haizhu, and Baiyun in Guangzhou City during Sep 30^th 2008 to Dec 31^th 2010 were divided into quitting group and control group based on dropping out of MMT or not. Results A total of 1 021 cases were investigated. Of them, 218 were in quitting group and 803 in control group; 933 were male and 88 female. The initial drug use ages were 23.11 years in the quitting group and 24. 80 years in the con-trol group. Average injecting drug costs were 191.09 and 154. 77 yuan respectively. Average injecting drug use frequencies in the past month were 105.24 and 106. 40 times. The multivariable logistic regression analy-sis showed the independent predictors of dropping out from the first three community-based MMT clinics in Guangzhou City included social contact with drug users in the past month （ OR = 1. 524） and age of the first time of drug using （ OR = 0. 773）. Conclusion The more social contacts with drug users in the past month and the less the initial drug use age, the easier dropping out of cormnunity-based MMT. Multiple interventions should be taken to prevent the patients from dropping out of MMT clinics and increase the retention of MMT.