酒精依賴(lài)患者住院治療后早期復(fù)發(fā)及血清S100B蛋白的預(yù)測(cè)效應(yīng)：6個(gè)月隨訪(fǎng)研究

酒精依賴(lài)患者住院治療后早期復(fù)發(fā)及血清S100B蛋白的預(yù)測(cè)效應(yīng)：6個(gè)月隨訪(fǎng)研究酒精依賴(lài)患者住院治療后早期復(fù)發(fā)及血清S100B蛋白的預(yù)測(cè)效應(yīng)：6個(gè)月隨訪(fǎng)研究

摘要：

目的：探討酒精依賴(lài)患者住院治療后早期復(fù)發(fā)的危險(xiǎn)因素和預(yù)測(cè)指標(biāo)，以及血清S100B蛋白的預(yù)測(cè)效應(yīng)。

方法：選取6個(gè)月內(nèi)完成住院治療的酒精依賴(lài)患者為研究對(duì)象，進(jìn)行隨訪(fǎng)研究。通過(guò)問(wèn)卷調(diào)查和臨床評(píng)估，評(píng)估早期復(fù)發(fā)的危險(xiǎn)因素。同時(shí)，收集血清樣本，檢測(cè)血清S100B蛋白，并分析其與早期復(fù)發(fā)的關(guān)系。

結(jié)果：共有185名酒精依賴(lài)患者完成了6個(gè)月的隨訪(fǎng)。在隨訪(fǎng)期間，有45人（24.3%）出現(xiàn)了早期復(fù)發(fā)。多元回歸分析顯示，早期復(fù)發(fā)與年齡、婚姻狀況、吸煙習(xí)慣、實(shí)施安置計(jì)劃的程度和使用替代藥物治療的情況有關(guān)。此外，血清S100B蛋白水平與早期復(fù)發(fā)顯著相關(guān)。在使用具有較高檢測(cè)靈敏度和特異度的血清S100B蛋白水平作為預(yù)測(cè)指標(biāo)時(shí)，其ROC曲線(xiàn)下面積為0.847（95%CI：0.774-0.921），診斷效能較高。

結(jié)論：年齡、婚姻狀況、吸煙習(xí)慣、實(shí)施安置計(jì)劃的程度和使用替代藥物治療等因素可能是酒精依賴(lài)患者早期復(fù)發(fā)的危險(xiǎn)因素。血清S100B蛋白水平是早期復(fù)發(fā)的predictor，可以作為早期復(fù)發(fā)風(fēng)險(xiǎn)的預(yù)測(cè)指標(biāo)。

關(guān)鍵詞：酒精依賴(lài)患者；住院治療；早期復(fù)發(fā)；S100B蛋白；預(yù)測(cè)效應(yīng)

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