脑梗死二级预防患者阿托伐他汀依从性降低的危险因素分析  

Analysis of risk factors about reduced atorvastatin compliance in patients with cerebral infarction secondary prevention

作　　者：陈梅[1] 郭明升[2] 刘娟[2] 武华[3] 马普红[4] CHEN Mei;GUO Ming-sheng;LIU Juan;WU Hua;MA Pu-hong(Department of Internal Medicine,Jiulong Service Branch Hospital of Jizhong Energy Fengfeng Group Co.,LTD.,Hebei Province,Handan 056500,China;Department of Neurology,General Hospital of Jizhong Energy Fengfeng Group Co.,LTD.,Hebei Province,Handan 056200,China;Department of Pharmacy,General Hospital of Jizhong Energy Fengfeng Group Co.,LTD.,Hebei Province,Handan 056200,China;CT/MR Room,General Hospital of Jizhong Energy Fengfeng Group Co.,LTD.,Hebei Province,Handan 056200,China)

机构地区：[1]冀中能源峰峰集团有限公司九龙服务分公司医院内科,河北邯郸056500 [2]冀中能源峰峰集团有限公司总医院神经内科,河北邯郸056200 [3]冀中能源峰峰集团有限公司总医院药学部,河北邯郸056200 [4]冀中能源峰峰集团有限公司总医院CT/MR室,河北邯郸056200

出　　处：《河北医科大学学报》2019年第2期149-152,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(20181744)

摘　　要：目的探讨脑梗死二级预防患者阿托伐他汀依从性降低的危险因素。方法选择急性脑梗死患者546例随访3个月。依据阿托伐他汀依从性分为依从性降低组和依从性未降低组,比较2组性别,年龄,神经功能评分,药物不同日用量例数,经济问题、中药替代、指导异常、遗忘误解、不良反应、缺乏信心发生率。分析脑梗死二级预防患者阿托伐他汀依从性降低的危险因素。结果调查结束时,21例患者失访,实际完成研究525例,其中患者阿托伐他汀依从性降低281例(53.5%)。依从性降低组与依从性未降低组性别、年龄、NIHSS评分、mRs评分和阿托伐他汀日用量差异无统计学意义(P>0.05);依从性降低组经济问题、中药替代、指导异常、遗忘误解、不良反应、缺乏信心发生率明显高于依从性未降低组,差异有统计学意义(P<0.05)。多元Logistic回归分析结果显示,经济问题、中药替代、指导异常、遗忘误解、不良反应、缺乏信心是阿托伐他汀依从性降低的危险因素。结论针对上述主观原因采取行之有效的措施,可减少甚至消除脑梗死二级预防期间阿托伐他汀依从性降低。Objective To investigate the risk factors about reduced atorvastatin compliance in patients with cerebral infarction secondary prevention.Methods The 546 patients with acute cerebral infarction were followed up for 3 months.All patients were divided into two groups according to the decrease of atorvastatin compliance or not.The following factors were compared between the two groups,including sex,age,neurological function,the number of patients with different daily doses of atorvastatin and incidence of following subjective causes,included economic problems,substitution of traditional Chinese medicine,abnormal guidance,forgetting and misunderstandings,adverse reactions and lack of confidence.Risk factors of reduced compliance of atorvastatin in patients with secondary prevention of cerebral infarction were analyzed.Results At the end of the investigation,21 patients lost their visits and 525 patients completed the study,among which 281 patients(53.5%)had decrease of atorvastatin compliance.There was no significant difference on sex,age,neurological function and the number of patients with different daily doses of atorvastatin between two groups(P>0.05).The incidence of economic problems,substitution of traditional Chinese medicine,abnormal guidance,forgetting and misunderstandings,adverse reactions and lack of confidence in the decrease of atorvastatin compliance group were significantly higher than those in the not decrease of atorvastatin compliance group(P<0.05).Economic problems,substitution of traditional Chinese medicine,abnormal guidance,forgetting and misunderstandings,adverse reactions and lack of confidence were the risk factors about reduced atorvastatin compliance by multivariate Logistic regression analysis.Conclusion Taking effective measures against the above subjective causes may reduce or even eliminate the decrease of atorvastatin compliance during the secondary prevention of cerebral infarction.

关 键 词：脑梗死 阿托伐他汀 服药依从性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]