缺血性脑卒中患者出院服药依从性与复发相关性  

Study on drug compliance and recurrence in discharged patients with ischemic stroke

作　　者：周莉[1] 袁云华[1] 陈晓飞 邓楠[1] 曾国利[1] 熊光[1] ZHOU Li;YUAN Yunhua;CHEN Xiaofei;DENG Nan;ZENG Guoli;XIONG Guang(Department of Neurology, Luzhou People's Hospital, Luzhou 646000, Sichuan, China)

机构地区：[1]泸州市人民医院神经内科,四川泸州646000

出　　处：《西部医学》2020年第6期883-886,共4页Medical Journal of West China

基　　金：四川省卫生健康委员会科研项目(17pJ091)。

摘　　要：目的分析急性缺血性脑卒中出院患者服药依从性与复发的关系。方法选取2017年1月~2018年12月我院内科收治的急性缺血性脑卒中患者200例,比较两组患者出院后12个月复发情况及预后。结果随访181例急性缺血性脑卒中患者中,复发60例,复发率为33.1%,其中死亡10例,死亡率为5.52%;患者出院后3、6、12个月服用他汀类药物、抗栓药物、降糖药物、降压药物服药依从性都呈下降趋势(P<0.05);两组患者文化程度、糖尿病、高血压及心脏病发生率、饮酒率、吸烟率、药物认知情况、疾病认知况、TOAST病因分型比较,差异有统计学意义(P<0.05);出院后依从性好组患者12个月的复发率、预后不良的所占比例低于依从性差组(P<0.05)。结论随出院时间延长,缺血性脑卒中患者他汀类药物、抗栓药物、降糖药物、降压药物的服药依从性均呈下降趋势,且受多种因素影响,因此,医院及社区、乡镇卫生院需加强对患者二级预防药物服用的健康教育及正确指引。Objective To analyze the relationship between drug compliance and recurrence in patients with acute ischemic stroke discharged.Methods 200 patients with acute ischemic stroke admitted to the Department of Neurology,Luzhou People's Hospital from January 2017 to December 2018 were selected.The days of compliance with medical advice≥80%of total follow-up days is considered as good drug compliance,otherwise is poor compliance.The drug compliance and adverse events of stroke recurrence within 12 months after discharge of enrolled patients were registered by monthly telephone follow-up or outpatient service.The recurrence and prognosis within 12 months of the two groups were compared after discharge.Results Among 181 cases of acute ischemic stroke,60 cases recurred,and the recurrence rate was 33.1%,including 10 cases died,the mortality rate was 5.52%.Compliance of those who took antithrombotic drugs,statins,antihypertensive drugs,and hypoglycemic drugs at 3,6 and 12 months after discharge showed a downward trend(P<0.05).There was statistically significance of comparison and differences in the educational level,incidence of hypertension,incidence of diabetes,incidence of heart disease,smoking rate,drinking rate,disease cognition,drug cognition,and TOAST etiology classification between the two groups(P<0.05).The recurrence rate and poor prognosis of patients in the good compliance group were lower than the poor compliance group(P<0.05).Conclusion The compliance of statins,antithrombotic drugs,hypoglycemic drugs and antihypertensive drugs in patients with ischemic stroke decreased with the time of discharge,and was affected by many factors.Therefore,hospitals,communities and township hospitals need to strengthen health education and correct guidance on the use of secondary preventive drugs.

关 键 词：脑卒中 脑缺血 服药依从性 复发 

分 类 号：R743.3[医药卫生—神经病学与精神病学]