抗高血压药物治疗依从性对高血压患者首发脑梗死的影响  

Impact of antihypertensive therapy compliance on risk of first-ever cerebral infarction among patients with essential hypertension

作　　者：徐心[1] 宋英魁[3] 耿清[4] 孔晓光[2] 陶莉[2] 胡晓蕾[1] 

机构地区：[1]哈尔滨医科大学附属第一医院神经内科,150001 [2]哈尔滨医科大学附属第一医院体检中心,150001 [3]济宁市第一人民医院急诊内科 [4]哈尔滨市第一医院神经内科

出　　处：《中华全科医师杂志》2009年第5期305-308,共4页Chinese Journal of General Practitioners

基　　金：黑龙江省卫生厅科研基金（2005-186）

摘　　要：目的探讨抗高血压药物治疗依从性对原发性高血压患者首次发生脑梗死的影响。方法选取2006年12月至2007年12月于我院诊治或体检的114例合并首发脑梗死的原发性高血压患者为观察组，以同期114例未发生脑梗死的原发性高血压患者为对照组，进行问卷调查及相关辅助检查，对抗高血压药物治疗依从性等研究因素进行单因素和多因素的logistic回归分析。结果依从性、高血压病程、吸烟史、饮酒史对高血压患者首发脑梗死的影响有统计学意义（P〈0．05）。相对于未治疗，依从性好是高血压患者首发脑梗死的保护性因素，OR值为0．429（95％CI0．186～0．993）；依从性差为其危险因素，OR值为2．142（95％CI1．052～4．364）。低量饮酒史为保护性因素，OR值为0．494（95％CI0．252—0．968）。相对于〈5年的高血压病程，≥10年病程是高血压患者首发脑梗死的危险因素，10～19年和≤20年的OR值分别为3．421、3．959。吸烟史也为危险因素，OR值为2．118（95％CI1．075～4．174）。结论抗高血压药物治疗依从性是原发性高血压患者首发脑梗死的一个重要影响因素。良好的依从性是保护性因素，对首发脑梗死有明确的预防作用；依从性差以及未治疗的高血压患者比依从性好者易患脑梗死。应采取措施提高患者抗高血压药物治疗的依从性。Objective To evaluate the impact of compliance with antihypertensive therapy in patients with essential hypertension on risk for their first-ever cerebral infarction. Methods Questionnaire survey and auxiliary examinations were conducted in 114 patients with essential hypertension hospitalized for acute cerebral infarction at the First Hospital Affiliated to Harbin Medical University during December 2006 to December 2007, as well as in another 114 patients with essential hypertensive without history of cerebral infarction as controls during the same period. Univariate and multivariate logistic regression analyses were performed to study the relationship between first-ever cerebral infarction and compliance with antihypertensive agents and other relevant factors. Results Antihypertensive agents compliance, course of hypertension, and history of smoking and alcohol drinking could significantly affect their first occurrence of cerebral infarction in patients with essential hypertension （P 〈0. 05）, with odds ratios （OR） of 0. 429 （95% CI0. 186 -0. 993） and 2. 142 （ 95% CI 1. 052 - 4. 364 ） for good and poor compliance with antihypertensive agents, respectively, as compared to those without antihypertensive treatment. Mild drinking was a protective factor for cerebral infarction with an OR of 0. 494 （95% CI 0. 252 - 0. 968 ）. Length of hypertension with 10 - 19- years and more than or equal to 20 years, as compared to those with less than five years of hypertension, was a risk factor for their first-ever cerebral infarction, with OR of 3.421 and 3. 959, respectively. Smoking was also a risk factor for it, with an OR of 2. 118 （95% CI 1. 075 - 4. 174 ）. Conclusions Compliance of essential hypertensive patients with antihypertensive therapy was an important factor that affect their contracting first-ever cerebral infarction. Good compliance could obviously refrain them from it. Patients with poor-compliance or without treatment prone to contract cerebral infarction more easily than those with g

关 键 词：抗高血压药物 病人依从 脑梗塞 

分 类 号：R544.1[医药卫生—心血管疾病] R544.105[医药卫生—内科学]