缺血性脑卒中二级预防中降脂治疗的现状及其影响因素  

Status of lipid-lowering therapy in secondary prevention of ischemic stroke patients and analysis of influential factors

作　　者：龙发青[1] 蔡毅[1] 苏庆杰[1] 曾超胜[1] 吴海荣[1] 吴映曼[1] 李鹏翔[1] 王德生[1] 陈聪[1] 

机构地区：[1]海南省农垦总医院神经内科,海南海口570031

出　　处：《海南医学》2013年第10期1413-1416,共4页Hainan Medical Journal

基　　金：2010年度海南省卫生厅重点科研课题项目(编号:琼卫2010重点-40);海南省自然科学基金项目(编号:310158)

摘　　要：目的调查分析缺血性脑卒中二级预防中降脂治疗的现状及影响因素，为改进缺血性脑卒中的二级预防工作提供依据。方法人选符合标准者为来自海南省10家综合性医院的1118例患者，调查患者人院时降脂药物的应用状况，采用单因素Logistic回归分析对可能的影响因素进行筛查，再进行多因素Logistic回归分析。结果降脂治疗知晓率为32．9％，治疗率为19.3％，达标率为1．1％。多因素Logistic回归分析显示，教育程度（OR=2．590，95％CI：1．425-4．736）、健康教育（OR=3．411，95％CI：1．675-7．989）、医疗保险（OR=5．162，95％CI：2．416-10．152）是患者服用降脂药物依从性的独立危险因素。患者性别、年龄、居住环境、婚姻状况等和降脂药物依从性无关。结论缺血性脑卒中二级预防中降脂治疗知晓率、治疗率、达标率低，应加强临床医生对降脂的认识，加强对脑卒中患者的健康教育，建议患者长期服药，消灭脑卒中二级预防中降脂防治力度不足的医源性因素。Objective To investigate the status of lipid-lowering therapy in the secondary prevention of ischemic stroke and identify the influential factors, and then provide clues for improving the secondary prevention. Methods A total of 1 118 patients who meet the conditions were admitted into the test, and all the patients came from 10 Hainan Province＇s general hospitals. Univariate analyses were first conducted to analyze the status of Lipid-lowering drugs, followed by multivariate logistic regression analysis. Result The rates of awareness, treatment and control of lip- id-lowering therapy were respectively 32.6%,19.3% and 1.1%. Multinomial logistic regression did select education（OR=2.590, 95%CI： 1.425-4.736）, health insurance （OR=5.162, 95%CI： 2.416-10.152）, health education（OR=3.411, 95%CI： 1.675-7.989） as the independent influential factors. Sex,age, living environment and marital status were not associated with the compliance of lipid-lowering therapy. Conclusion The rates of awareness, treatment and control of lipid-lower- ing therapywere low, and hence clinicians＇ understanding of lipid-lowering should be improved, the health education to stroke patients should be strengthened, and medication should be recommended so as to eliminate iatrogenic factors of in- adequate lipid-lowering prevention in the secondary prevention of ischemic stroke.

关 键 词：缺血性脑卒中 血脂 二级预防 

分 类 号：R743.3[医药卫生—神经病学与精神病学]