原发性高血压合并腔隙性脑梗死患者的抗高血压用药依从性分析  

Analysis on compliance with antihypertensive therapy in patients with cerebral lacuna infarct and hypertension

作　　者：徐心[1] 耿清[2] 宋英魁[3] 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]哈尔滨市第一医院神经内科 [3]济宁市第一人民医院急诊内科

出　　处：《中华全科医师杂志》2010年第3期198-200,共3页Chinese Journal of General Practitioners

基　　金：基金项目：黑龙江省卫生厅科研基金（2005-186）

摘　　要：采用回顾性问卷式调查，选择2007年1月1日至2008年1月1日于我院神经内科及体检中心就诊或体检的、头部CT证实有腔隙性脑梗死的原发性高血压患者80例为研究组，以同期就诊或体检头部CT显示正常的高血压患者80例为对照组，对两组抗高血压药物治疗的依从性等指标进行比较及多因素分析。结果显示，研究组依从好者少于对照组（X^2=16．661，P=0．000），不用药者多于对照组（X^2=7．605，P=0．009）。对照组长效药物应用比例高于研究组（x^2=10．736，P=0．001）。每组中依从良好者平均血压及血压达标情况均好于依从差及不服药者。logistic回归分析显示，依从性好、在一定范围内收缩压控制越好，腔隙性脑梗死的发生率越低（P〈0．05或〈0．01）；高血压的病程越长，腔隙性脑梗死发生率越高（P〈0．01）。提示合理选择长效抗高血压药物，提高患者用药依从性，将血压控制在合理范围内，对预防原发性高血压患者腔隙性脑梗死的发生有积极重要的意义。This retrospective case control study compared patient compliance and blood pressure control in hypertensive patients with and without cerebral lacuna infarction on CT in the first affiliated hospital of Harbin Medical University during 2007-01-01 to 2008-01-01. Chi-square test, t test and conditional logistic regression were applied for statistic analysis. We found that, in contrast with the lacuna infarction group, the control group had better compliance with antihypertensive therapy （X^2 = 16. 661, P = 0. 000） and more use of long acting medications（ X^2 = 10. 736,P = 0. 001 ）. In both groups, blood pressure was lower in those patients with better compliance. Good compliance and adequate control of blood pressure were statistically associated with lower incidence of cerebral lacuna infarction. We conclude that good control of blood pressure, improved compliance with antihypertensive therapy and use of long acting medications may help to reduce the incidence of cerebral lacuna infarction in hypertensive patients.

关 键 词：脑梗塞 高血压 病人依从 

分 类 号：R544.1[医药卫生—心血管疾病] R743.33[医药卫生—内科学]