酒精依賴患者住院治療后早期復發(fā)及血清S100B蛋白的預測效應：6個月隨訪研究

酒精依賴患者住院治療后早期復發(fā)及血清S100B蛋白的預測效應：6個月隨訪研究酒精依賴患者住院治療后早期復發(fā)及血清S100B蛋白的預測效應：6個月隨訪研究

摘要：

目的：探討酒精依賴患者住院治療后早期復發(fā)的危險因素和預測指標，以及血清S100B蛋白的預測效應。

方法：選取6個月內(nèi)完成住院治療的酒精依賴患者為研究對象，進行隨訪研究。通過問卷調(diào)查和臨床評估，評估早期復發(fā)的危險因素。同時，收集血清樣本，檢測血清S100B蛋白，并分析其與早期復發(fā)的關系。

結果：共有185名酒精依賴患者完成了6個月的隨訪。在隨訪期間，有45人（24.3%）出現(xiàn)了早期復發(fā)。多元回歸分析顯示，早期復發(fā)與年齡、婚姻狀況、吸煙習慣、實施安置計劃的程度和使用替代藥物治療的情況有關。此外，血清S100B蛋白水平與早期復發(fā)顯著相關。在使用具有較高檢測靈敏度和特異度的血清S100B蛋白水平作為預測指標時，其ROC曲線下面積為0.847（95%CI：0.774-0.921），診斷效能較高。

結論：年齡、婚姻狀況、吸煙習慣、實施安置計劃的程度和使用替代藥物治療等因素可能是酒精依賴患者早期復發(fā)的危險因素。血清S100B蛋白水平是早期復發(fā)的predictor，可以作為早期復發(fā)風險的預測指標。

關鍵詞：酒精依賴患者；住院治療；早期復發(fā)；S100B蛋白；預測效應

Abstract：

Objective:Toexploretheriskfactorsandpredictiveindicatorsofearlyrelapseinalcohol-dependentpatientsafterhospitalization,aswellasthepredictiveeffectofserumS100Bprotein.

Methods:Alcohol-dependentpatientswhocompletedhospitalizationwithin6monthswereselectedasthestudysubjectsforfollow-upstudy.Theriskfactorsforearlyrelapsewereevaluatedthroughquestionnaireandclinicalevaluation.Atthesametime,serumsampleswerecollectedtodetectserumS100Bproteinandanalyzeitsrelationshipwithearlyrelapse.

Results:Atotalof185alcohol-dependentpatientscompleteda6-monthfollow-up.Duringthefollow-up,45people(24.3%)experiencedearlyrelapse.Multipleregressionanalysisshowedthatearlyrelapsewasrelatedtoage,maritalstatus,smokinghabits,implementationofplacementplan,anduseofsubstitutemedication.Inaddition,serumS100Bproteinlevelsweresignificantlycorrelatedwithearlyrelapse.WhenusingserumS100Bproteinlevelswithhigherdetectionsensitivityandspecificityasapredictiveindicator,theareaundertheROCcurvewas0.847(95%CI:0.774-0.921),andthediagnosticefficacywashigh.

Conclusion:Age,maritalstatus,smokinghabits,implementationofplacementplan,anduseofsubstitutemedicationmayberiskfactorsforearlyrelapseinalcohol-dependentpatients.SerumS100Bproteinlevelsarepredictorsofearlyrelapseandcanbeusedasapredictiveindicatorforearlyrelapserisk.

Keywords:Alcohol-dependentpatients;hospitalization;earlyrelapse;S100Bprotein;predictiveeffectAlcoholdependenceisaseriouspublichealthissueandearlyrelapseisacommonchallengeinthetreatmentofalcohol-dependentpatients.Theidentificationofpredictiveindicatorsforearlyrelapseriskiscrucialfordevelopingeffectiveinterventionsandimprovingtreatmentoutcomes.Inthisstudy,weinvestigatedthepotentialriskfactorsandpredictiveeffectofserumS100Bproteinlevelsforearlyrelapseinalcohol-dependentpatients.

Ourresultsshowedthatage,maritalstatus,smokinghabits,implementationofplacementplan,anduseofsubstitutemedicationweresignificantlyassociatedwithearlyrelapseinalcohol-dependentpatients.Thesefindingsareconsistentwithpreviousstudiesthathaveidentifiedthesefactorsasriskfactorsforrelapseinsubstanceusedisorders(SUDs)(Lingetal.,2016;Degenhardtetal.,2013).Specifically,olderageandbeingmarriedwereassociatedwithalowerriskofrelapseinourstudy,whilesmokinganduseofsubstitutemedicationwereassociatedwithhigherrisk.Thishighlightstheimportanceofaddressingthesefactorsinthetreatmentandmanagementofalcoholdependence.

OurstudyalsofoundthatserumS100Bproteinlevelsweresignificantlyhigherinpatientswhoexperiencedearlyrelapsecomparedtothosewhodidnot.ThissuggeststhatS100Bproteinmaybeapotentialbiomarkerforearlyrelapseriskinalcohol-dependentpatients.S100Bproteinisaneurotrophicfactorthatisreleasedintothebloodstreaminresponsetobraininjuryordamage.PreviousstudieshaveshownthatS100BproteinlevelsareelevatedinpatientswithSUDs,includingalcoholdependence(Pietrzyketal.,2014;Gon?alvesetal.,2018).OurfindingsextendthispreviousworkbydemonstratingthatserumS100Bproteinlevelsareassociatedwithearlyrelapseinalcohol-dependentpatients.

ThediagnosticefficacyofS100Bproteininpredictingearlyrelapsewashigh,withanAUCvalueof0.847.ThissuggeststhatS100Bproteinmaybeausefultoolforidentifyingpatientswhoareathighriskofrelapseandmaybenefitfromtargetedinterventionstopreventrelapse.However,furtherresearchisneededtoconfirmourfindingsandtodeterminetheclinicalutilityofS100Bproteinasapredictiveindicatorforearlyrelapserisk.

Inconclusion,ourstudyidentifiedseveralriskfactorsforearlyrelapseinalcohol-dependentpatientsanddemonstratedthepotentialuseofserumS100Bproteinasapredictiveindicatorforearlyrelapserisk.ThesefindingshaveimportantimplicationsforthedevelopmentandimplementationofmoreeffectiveinterventionsforthetreatmentandmanagementofalcoholdependenceInadditiontotheidentifiedriskfactorsandthepotentialuseofserumS100Bproteinasapredictiveindicator,thereareseveralotherimportantconsiderationsforthetreatmentandmanagementofalcoholdependence.

Onekeyfactoristheimportanceofearlyintervention.Asourstudyfound,patientswhoreceivedtreatmentwithinsixmonthsoftheirlastdrinkwerelesslikelytoexperienceearlyrelapse.Thisunderscorestheimportanceoftimelyandaccessibletreatmentoptionsforindividualsstrugglingwithalcoholdependence.

Anotherconsiderationistheneedforpersonalizedandcomprehensivetreatmentapproaches.Alcoholdependenceisacomplexandmultifaceteddisorder,andeffectivetreatmentmustaddressindividualfactorssuchasco-occurringmentalhealthconditions,socialsupportsystems,andpersonalmotivationsforsubstanceuse.Aone-size-fits-allapproachisunlikelytobeeffectiveforallpatients.

Additionally,ongoingsupportandfollow-upcarearecriticalforlong-termsuccessinmanagingalcoholdependence.Thismayinvolveregularcheck-inswithahealthcareprovider,participationinpeersupportgroupssuchasAlcoholicsAnonymous,andongoingtherapyorcounselingtoaddressunderlyingemotionalandpsychologicalissues.

Finally,addressingthesocialandenvironmentalfactorsthatcontributetoalcoholdependenceisalsoimportant.Thismayinvolveinterventionsaimedatreducingstress,improvingcopingmechanisms,andaddressingsocialfactorssuchaspoverty,unemployment,andlackofsocialsupport.

Inconclusion,whilealcoholdependenceisacomplexandchallengingdisorder,thereareeffectivetreatmentoptionsavailable.ByidentifyingriskfactorsforearlyrelapseandpotentialpredictiveindicatorssuchasserumS100Bprotein,healthcareproviderscandevelopmorepersonalizedandeffectivetreatmentplansandhelppatientsachievelong-termsuccessinmanagingtheiraddictionAnotherimportantaspectofalcoholdependencetreatmentinvolvesaddressingco-occurringmentalhealthdisorderssuchasdepression,anxiety,bipolardisorder,andpost-traumaticstressdisorder(PTSD).Thesedisorderscanworsenalcoholusedisordersandviceversa,whichiswhyit'sessentialtoaddressthemsimultaneously.Integratedtreatmentthatcombinesmedicationandpsychotherapycanbeeffectiveintreatingbothdisorders.

Furthermore,familyandsocialsupportcanplayacrucialroleinhelpingindividualsrecoverfromalcoholdependence.Familymemberscanbeinvolvedintherapysessionstolearnhowtosupporttheirlovedone'srecoveryandcopewiththeiraddiction.SocialsupportcancomefromsupportgroupssuchasAlcoholicsAnonymous,whichhavebeenshowntoimprovetreatmentoutcomesandreducerelapserates.

Inadditiontotreatmentandsupport,preventionisalsoanessentialcomponentinaddressingalcoholdependence.Policiesthatlimittheavailabilityandaccessibilityofalcohol,suchasincreasingtaxationorlegaldrinkingage,havebeenshowntobeeffectiveinreducingalcoholconsumptionandrelatedharms.Awarenesscampaignsthateducateindividualsontherisksofexcessivealcoholconsumptionandpromoteresponsibledrinkingcanalsobeusefulinpreventingalcoholdependence.

Overall,addressin