缺血性卒中患者抗栓药依从性研究  

Compliance with Antithrombotic Treatments in Secondary Prevention of Ischemic Stroke

作　　者：张瑛[1] 苗玲[1] 林岩[1] 沈沸[1] 李红伟[1] 陆钦池[1] 李焰生[1] 

机构地区：[1]上海交通大学医学院附属仁济医院神经内科,200127

出　　处：《国际脑血管病杂志》2007年第4期262-264,共3页International Journal of Cerebrovascular Diseases

基　　金：基金项目：上海市科委重大攻关项目（03DZ19704）

摘　　要：目的：评估缺血性卒中患者起病1年后使用抗栓药的依从性及其影响因素。方法：由住院病历中获取连续出院的缺血性卒中患者的一般资料、是否应用抗栓药及其种类，对其中应用抗栓药的患者在出院后1年进行电话随访，调查卒中后1年时抗栓治疗的依从性，同时对影响抗栓药依从性的相关因素进行了分析。结果：连续出院的缺血性卒中患者225例，应用抗栓药患者201例（其中95．0％使用阿司匹林）。完成出院1年时随访176例，其中67．0％继续抗栓治疗。Logistic回归分析显示，应用阿司匹林（OR7．028，95％CI1．241～39．784）、卒中门诊随访（OR2．257，95％CI1．050～4．764）、功能预后好（MRS评分〈2分）（ORl．337，95％C10．997～1．793）为依从性良好的独立预测因素。结论：在缺血性卒中二级预防中，抗栓治疗的依从性尚不能令人满意，应用阿司匹林、卒中门诊随访、功能预后较好有助于提高长期抗栓治疗的依从性。Objective： To assess the compliance of antithrombotic agents one year after the onset of symptoms in patients with ischemic stroke and its influencing factors. Methods： The general data of comecutive discharged patients with ischemic stroke, and whether antithrombotic agents were used or not and their types were obtained from medical records. Among the patients who used antithrombotic agents were followed-up through telephone interviews one year after their discharge. The compliance of antithrombotic treatment at one year was imestigated, and at the same time, the related factors that influenced the compliance of antithrombotic agents were analyzedagesults： Of the 225 comecutixe discharged patients with ischemic stroke, 201 were treated with antithrombotic agents （95% of them used aspirin）. At one year after discharge, the follow-up had been completed in 176 patients, and 67. 0% of them were continuing antithrombotic treatment. Logistic regression analyses rexealed that the application of aspirin （odds rate I ORI 7. 028, 95% C/1. 241-39. 784）, stroke clinic follow-up （OR 2. 257, 95% CI 1. 050-4. 764）, and good functional prognosis （MRS 〈2） （OR 1. 337, 95% CI 0. 997-1. 793） were the independent predictors for good compliance. Conclusions： The compliance of antithrornbotic treatment has not been satisfactory in the secondary prexention of ischemic stroke. The application of aspirin, stroke clinic follow-up, and better functional prognosis are helpful to improving the long-term compliance of antithrombotic treatment.

关 键 词：缺血性卒中 抗栓治疗 依从性 

分 类 号：R74[医药卫生—神经病学与精神病学]