社区老年人口服抗栓药物预防心脑血管疾病的现况与对策分析  

A survey on the prevention of cardiovascular and cerebrovascular diseases with oral antithrombotic drugs in an elderly community

作　　者：杨红[1] 刘俊[2] 冯志刚[1] 高大勇[1] 宋卫华[2] YANG Hong;LIU Jun;FENG Zhi-gang;GAO Da-yong;SONG Wei-hua(Yongdinglu Community Health Station of Aerospace Central Hospital,Beijing 100036,China;Department of Cardiology,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]北京市航天中心医院永定路社区卫生服务中心,北京市100036 [2]中国医学科学院,北京协和医学院,国家心血管病中心,阜外医院心内科

出　　处：《中国心血管病研究》2021年第2期107-110,共4页Chinese Journal of Cardiovascular Research

基　　金：国家重点研发计划(2018YFC1315602);航天中心医院科研基金(YN201804)。

摘　　要：目的分析北京某社区老年人口服抗栓药物进行心脑血管疾病一级预防和二级预防的应用现状。方法2019年10月至2020年3月期间在北京市翠微西里由社区医师通过标准问卷调查老年人的高血压、冠心病、糖尿病、脑梗塞、心房颤动等系统性疾病的患病情况和长期口服抗血小板聚集(APA)与抗凝(AC)药物治疗情况。结果328例老年人参与调查,其中158例(48.2%)长期口服抗栓药物治疗,144例(43.9%)口服APA药物,20例(6.1%)口服AC药物。罹患高血压、糖尿病、脑梗塞、冠心病的老年人仍未抗栓治疗比例分别为44.9%、45.0%、36.7%、8.1%。心房颤动患者AC治疗比例仅为50%,而与APA治疗患者的卒中风险和出血风险无差异。合并1或2种疾病的老年人占大多数(约占26.2%或28.7%),但其抗栓治疗比例仅为29.3%~61.7%。结论社区医师仍需加强对老年人抗栓治疗的教育,特别是罹患疾病较少的患者;房颤患者抗凝治疗亟待提高。Objective To investigate the application status of oral antithrombotic drugs for the prevention of cardiovascular and cerebrovascular diseases among the elderly in community.Methods The incidence of hypertension,coronary heart disease,diabetes,cerebral infarction,atrial fibrillation and other systemic disorders in the elderly in the Cuiweixili community and the long-term oral antiplatelet aggregation(APA)and anticoagulation(AC)drug therapy were investigated by standard questionnaire from October 2019 to March 2020.Results Among the 328 elderly patients in the community,158(48.2%)received long-term oral antithrombotic drug therapy,144(43.9%)received oral APA drug and 20(6.1%)received oral AC drug.The proportion of patients with hypertension,diabetes,cerebral infarction and coronary heart disease without antithrombotic treatment was 44.9%,45.0%,36.7%and 8.1%respectively.The AC treatment proportion was only 50%in patients with atrial fbrillation.Most of the elderly had one or two of the above diseases,but only 29.3%to 61.7%were treated with anthrombotic therapy.Conclusion The proportion of oral antithrombotic drugs for primary and secondary prevention in the community elderly still needs to be improved,especially in patients with fewer diseases and anticoagulation treatment in patients with atrial fibrillation needs to be improved urgently.

关 键 词：老年 社区 抗栓药物 预防 

分 类 号：R54[医药卫生—心血管疾病]