酒精依赖患者住院治疗后早期复发及血清S100B蛋白的预测效应：6个月随访研究

酒精依赖患者住院治疗后早期复发及血清S100B蛋白的预测效应：6个月随访研究酒精依赖患者住院治疗后早期复发及血清S100B蛋白的预测效应：6个月随访研究

摘要：

目的：探讨酒精依赖患者住院治疗后早期复发的危险因素和预测指标，以及血清S100B蛋白的预测效应。

方法：选取6个月内完成住院治疗的酒精依赖患者为研究对象，进行随访研究。通过问卷调查和临床评估，评估早期复发的危险因素。同时，收集血清样本，检测血清S100B蛋白，并分析其与早期复发的关系。

结果：共有185名酒精依赖患者完成了6个月的随访。在随访期间，有45人（24.3%）出现了早期复发。多元回归分析显示，早期复发与年龄、婚姻状况、吸烟习惯、实施安置计划的程度和使用替代药物治疗的情况有关。此外，血清S100B蛋白水平与早期复发显著相关。在使用具有较高检测灵敏度和特异度的血清S100B蛋白水平作为预测指标时，其ROC曲线下面积为0.847（95%CI：0.774-0.921），诊断效能较高。

结论：年龄、婚姻状况、吸烟习惯、实施安置计划的程度和使用替代药物治疗等因素可能是酒精依赖患者早期复发的危险因素。血清S100B蛋白水平是早期复发的predictor，可以作为早期复发风险的预测指标。

关键词：酒精依赖患者；住院治疗；早期复发；S100B蛋白；预测效应

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;Gonçalvesetal.,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