脑梗死／短暂性脑缺血发作住院患者二级预防依从性研究及90天随访  

A survey on cerebral infarction/transient ischemic attack inpatients compliance with secondary stroke prevention and follow-up 90 days

作　　者：马锐华[1] 王拥军[1] 王春雪[1] 赵性泉[1] 王伊龙[1] 许明杰[2] 魏明 李尧[4] 张茁[5] 张微微[6] 王力[5] 林琅[6] 李红涛[7] 郑婷[1] 王献伟[1] 李菁晶[1] 吕莹[2] 齐冬[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经内科,100050 [2]北京垂杨柳医院神经内科 [3]北京和平里医院神经内科 [4]北京第六医院神经内科 [5]首都医科大学附属北京安贞医院神经内科 [6]北京军区总医院神经内科 [7]北京大兴区医院神经内科

出　　处：《中华医学杂志》2008年第37期2618-2622,共5页National Medical Journal of China

基　　金：北京市科委重大课题基金资助项目（D0905004000011）

摘　　要：目的了解北京住院脑梗死／短暂性脑缺血发作（TIA）患者对于住院期间及出院90d二级预防药物及行为修正的依从性现状。方法调查2006年10月1日至2007年5月1日参加研究医院的符合入组标准的连续住院脑梗死及TIA患者对于肾素-血管紧张素转换酶抑制剂（ACEI）／血管紧张素Ⅱ受体拮抗剂（ARB）、他汀药物、抗血小板药物治疗的使用率，戒烟、控制体重等行为修正率并随访90d。结果入组患者中使用抗血小板及他汀等药物及行为修正率偏低，并且在出院90d这一比例进一步降低。结论医生应关注患者有明确循证医学依据的二级预防药物及行为修正的依从性，并采取行之有效的措施提高患者药物治疗及行为修正的依从性。Objective Poor compliance with evidence-based-medicine guidelines could significantly influence the effect of stroke prevention strategies. The objectives of this survey are to investigate the current status in Beijing of cerebral infarction/TIA（ transient ischemic attack） inpatients＇ adherence to the evidencebased- medicine secondary prevention and behavior modifications both at the discharge and at 90-day follow up. Methods The survey included cerebral infarction/ TIA patients successively admitted from 1, Oct 2006 to 1, May 2007, used ACEI/ARB, Statin, anti-platelet agents therapy, accepted carotid endarterctomy or angioplasty or stent, and modified behaviors to stop smoking and control weight. Data of patients during hospitalization were obtained from the medical documents in the inpatient department of 7 centers. The detailed information included the medicine therapy, lifestyle modifications, patients＇ social demographic background （age, sex, education and way of payment）, major risk factors for stroke, and ischemic event subtypes （TIA or cerebral infarction）. Above information of part of patients were collected through telephone interview at 90- day follow-up if the patients were not able to visit the clinic. Results 708 cerebral infarction/TIA inpatients who didn＇t have contraindications were included. Among them, the patents who haven＇t used anti-platelet agents, nor taken statin, nor accepted ACEI/ARB were about 0. 4% , 41.8% and 63. 6% respectively. Neither 27% of the patients have accepted the instructions on stop smoking. While about 588 patients suitable to drug therapy were followed up at 90 days, but the percentage of these patients who haven＇t compliance on anti-platelet agents, statin, ACEI/ARB was 26. 9%, 52.6% and 59.4% respectively. Only 66.9% of the smoking patients have received the doctor instructions on smoking cessation. Conclusion Stroke recurrence rate in China is higher than that of average figures in western countries. One of the key reasons of high recurrence of

关 键 词：脑梗死 脑缺血发作 短暂性 病人依从 二级预防 

分 类 号：R686[医药卫生—骨科学]