【摘要】 目的:调查盐酸纳曲酮(NTX)预防海洛因成瘾者戒毒后复吸的效果及其影响坚持服药的因素。方法和对象:应用回顾性调查方法,在广东、北京、浙江(宁波)等三地区进行调查。调查对象入组条件为:(1)使用过NTX;(2)自愿参加调查,依从性较好,有严重身心疾病患者除外。主要调查内容:(1)NTX作为维持用药的效果与可接受性;(2)服药人员中偷吸毒品或复发情况;(3)服药期间滥用海洛因的主观效应;(4)NTX的不良反应分布及发生率。结果:共调查有效服药人员531例,其中广东、北京、宁波分别为438、83和10例。平均NTX使用时间5.1±s7.0(0.3-84)月;平均日使用剂量45.5 mg。39.4%的被调查者在服用NTX期间偷吸海洛因无任何欣快感;在服用NTX前后滥用海洛因的欣快感分别为8.1 cm±s2.2 cm和2.8 cm±s2.5 cm(VAS值)(t值=38.626,P=0.000)。57.6%(306/531)的服药者主诉服药后出现药物不良反应,511例接受过肝功能(GPT)检测者(实际应答GPT值人数为95人)的平均GPT水平为36.2±s26.0单位,其中大于40单位的22人,占有效应答人数的23.2%。对NTX的认知和可接受性调查显示,多数被调查对象(87.2%)表示愿意长期服用NTX。结论:纳曲酮是一个有效的预防海洛因成瘾者戒毒后复发的药物;多数服药人员有希望通过服药预防复发的主观意愿,但也存在障碍/局限持续使用的因素。更多还原

【Abstract】 Objective:To evaluate the efficacy of naltrexone(NTX) as a maintenance pharmacotherapy for relapse prevention treatment in heroin addicts,and the factors influencing NTX use.Methods:A multi-center retrospective investigation was carried out in drug dependent treatment agencies based in the regions of Guangdong,Beijing and Zhejiang.All the subjects were opiate dependent clients and met the following criteria:(1) had taken NTX regularly on family basis;(2) agreed to participate in this study,and no severe organic diseases or psychiatric disorders.The outcomes of NTX treatment assessed were:(1) the acceptability and efficacy for maintenance treatment;(2) heroin re-use or relapse during NTX maintenance therapy and the reasons;(3) subjective euphoria associated with heroin use before and during NTX maintenance therapy;(4)presence of adverse reactions of NTX.Results:A total of 531 eligible clients who had the experience of NTX use completed the survey.The mean duration of NTX maintenance therapy was 5.1±s 7.0(0.3-84) months.The mean daily dose of NTX was 45.5 mg.39.4%(209/531) of the clients experienced no any subjective euphoria when they tried to re-use heroin during NTX use.The mean value of subjective euphoria for heroin before and during NTX maintenance therapy by VAS was 8.1 cm±s 2.2 cm and 2.8 cm±s 2.5 cm,respectively(t=38.626;P=0.000).57.6%(306/531) had experienced adverse drug effects and 23.2%(22/95) had their GPT more than 40 unit(the average 36.2±s 26.0).The knowledge and acceptance of NTX revealed that 87.2% would like to take NTX for longtime.Conclusion:NTX appears to be a promising pharmacotherapy for relapse prevention in heroin addicts,and particularly in family or community based maintenance therapy in China.更多还原