南通地区缺血性卒中二级预防药物应用现状及依从性随访分析  

Application Status and Compliance of Secondary Prevention Medication for Ischemic Stroke in Nantong Area: A Follow-up Study

作　　者：缪兴红 姜建芳[1] 江英[1] MIAO Xinghong;JIANG Jianfang;JIANG Ying(The Second People’s Hospital of Nantong City,Nantong 226002,China)

机构地区：[1]江苏省南通市第二人民医院,江苏南通226002

出　　处：《中国医学创新》2020年第27期156-160,共5页Medical Innovation of China

基　　金：南通市科技计划项目(YYZ17045)。

摘　　要：目的:了解南通地区缺血性卒中二级预防药物的应用现状,并对其依从性的影响因素进行分析。方法:连续纳入南通市第二人民医院缺血性卒中患者328例,于出院后3、6、12个月门诊或电话随访,记录患者二级预防药物应用情况及停药原因,并采用logistic回归分析影响服药依从性的因素。结果:出院后3、6、12个月,二级预防药物使用率逐渐降低,尤其是抗血栓药物和降脂药物下降明显(P<0.01)。出院后12个月,抗血栓药物和降脂药物的服用率分别为55.16%、58.80%。抗血栓药物、降脂药物自行停用最多原因为症状改善和不了解服药疗程,而降压药物、降糖药物自行停用最多原因为检查指标正常和症状改善。文化程度、高脂血症病史和医疗付费方式对抗血栓药物与降脂药物服药的依从性均有影响(P<0.05);经logistic回归分析,显示高中以下文化程度均是抗血栓药物与降脂药物服药依从性差的影响因素,而有高脂血症病史、医保或公费均是抗血栓药物与降脂药物服药依从性好的影响因素。结论:南通地区缺血性卒中二级预防药物应用现状不容乐观,应加强二级预防用药的宣传与教育,以提高患者服药依从性。Objective:To investigate the application status of secondary prevention medication for ischemic stroke in Nantong area,and to analyze the influencing factors of treatment compliance.Method:Data of 328 patients with ischemic stroke in the Second People’s Hospital of Nantong City were continuously collected.At 3,6 and 12 months after discharge,the application status of secondary prevention medication and the reasons for discontinuation were recorded through outpatient or telephone follow-up.The factors affecting treatment compliance were analyzed using logistic regression analysis.Result:At 3,6 and 12 months after discharge,the use rate of secondary preventive medication was gradually reduced,especially for antithrombotic medication and lipid-lowering medication (P<0.01).The use rate of antithrombotic medication and lipid-lowering medication were 55.16% and 58.80% at 12 months after discharge.The most common reasons for antithrombotic medication and lipid-lowering medication were the improvement of symptoms and ignorance of the course of treatment,while the most common reasons for the discontinuation of antihypertensive medication and antidiabetic medication were the normal examination indexes and the improvement of symptoms.The compliance of antithrombotic medication and lipid-lowering medication was affected by the degree of education,history of hyperlipidemia and medical payment (P<0.05).Logistic regression analysis showed that education level below high school was the influencing factor of poor compliance of antithrombotic medication and lipid-lowering medication,while history of hyperlipidemia,medical insurance or public expense were the influencing factors of good compliance of antithrombotic medication and lipid-lowering medication.Conclusion:The application status of secondary prevention medication for ischemic stroke in Nantong area was not optimistic,the promotion and education should be strengthened to improve treatment compliance.

关 键 词：缺血性卒中 二级预防 现状 依从性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]