缺血性脑卒中患者抗栓治疗调查  

Survey on antithrombotic treatment in patients with ischemic stroke

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

机构地区：[1]上海交通大学医学院仁济医院神经内科,上海200127

出　　处：《上海交通大学学报（医学版）》2007年第8期1008-1010,共3页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的调查缺血性脑卒中二级预防中抗栓药物的应用情况及影响因素。方法获取225例缺血性脑卒中患者的一般资料、是否应用抗栓药物及其种类；在患者出院后1a进行电话随访，了解患者抗栓药物用药情况、随诊方式和功能结局。结果212例患者有抗栓药物应用指征，其中未用抗栓药物的11例（5．2％）。201例应用抗栓药物的患者中：应用阿司匹林的占95．0％；完成出院1a时电话随访者176例，其中67．0％的患者依从性良好。应用非阿司匹林药物者依从性较差（OR=0．149，95％CI为0．029～0．764）。卒中门诊随访（OR=2．449，95％CI为1．174～5．109）、较好的功能预后（修订的Rankin评分〈2）（OR=1．939，95％CI为1．024～3．670）可促进患者对抗栓药物的依从。结论缺血性脑卒中二级预防中抗栓治疗尚不令人满意，值得进一步重视。To investigate effects of antithrombotic treatment of secondary prevention to patients with ischemia stroke. Methods Data were obtained from hospital records of 225 patients with ischemic stroke, including use and types of antithrombotic drugs. Phone calls follow-up at one year after discharge from hospital were made to get states of drug use, out-patient manners, and function prognosis. Results Among the 225 patients, 212 had indication for antithrombotic treatment, but 11 （5.2%） did not use any antithrombotic drugs. Two hundred and one patients who underwent antithrombotic treatment were all receiving antiplatelet agents and 95% with aspirin. One year later, 176 cases could finally be evaluated, which 67.0% were still under antithrombotic treatment. Administration of non-aspirin antithrombotic drugs （ OR = 0. 149,95% CI 0. 029 - 0. 764） had significant negative effects on compliance. Stroke outpatient clinic （ OR = 2. 449,95% CI 1. 174 - 5. 109） and better function prognosis （ modified Rankin scale 〈 2 ） （ OR-1. 939,95% CI 1. 024 - 3. 670） were able to promote compliance with antithrombotic treatment in stroke patients for secondary prevention. Conclusion Use of evidence-based antithrombotic treatment remains suboptimal. The results suggest that doctors should pay more attention to antithrombotic therapy in the secondary prevention of stroke.

关 键 词：缺血性脑卒中 抗栓治疗 二级预防 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R969.3[医药卫生—临床医学]