上海某社区动脉粥样硬化性心血管病高危人群中服用指南导向预防性药物的调查  

A survey of guideline directed prophylactic drug use among high risk population of atherosclerotic cardiovascular disease in a community of Shanghai

作　　者：方华 张高峰 王娜[3] 李洁 沈颖 郑俊婷 单知农 史佳音 FANG Hua;ZHANG Gaofeng;WANG Na;LI Jie;SHEN Ying;ZHENG Junting;SHAN Zhinong;SHI Jiayin(General Practice Department of Gumei Community Health Service Center of Minhang District,Shanghai 201102,China;Department of Cardiology of Shanghai Fifth People’s Hospital,and Center of Community-Based Health Research Affiliated to Fudan University,Shanghai 200240,China;Public Health School of Fudan University,Shanghai,200032,China)

机构地区：[1]上海市闵行区古美社区卫生服务中心全科,上海201102 [2]复旦大学附属上海市第五人民医院心内科,复旦大学社区健康研究中心(筹),上海200240 [3]复旦大学公共卫生学院,上海200032

出　　处：《上海医药》2021年第10期34-36,41,共4页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:了解上海某社区动脉粥样硬化性心血管病(ASCVD)高危人群预防性用药的情况以及影响因素。方法:来自古美社区卫生服务中心慢病管理平台2018年完成建档、且资料完整的60岁及以上的ASCVD高危对象(10年心血管病发病危险为10%~15%)1141例,其中男性496例,女性645例,年龄为63~81岁,平均年龄(72.4±4.7)岁。通过电子处方系统获取该人群近1年内的药物治疗情况。经电话访谈确认相关信息。结果:抗血栓药物服用比例为40.5%,糖尿病、LDL-c达标、无规则运动的人群的服用比例较高(P<0.05)。他汀类药物服用比例为43.5%,LDL-c达标和无规律运动人群的服药比例较高(P<0.05)。logistic回归分析显示,LDL-c未达标、吸烟和规律运动是不服用抗血栓药物的影响因素(P<0.05);LDL-c未达标和规律运动是不服用他汀类药物的影响因素(P<0.05)。结论:社区ASCVD高危人群中应用抗血栓药物和他汀类药物的比例偏低,与LDL-c不达标及运动习惯相关。需要进一步加强预防性用药的宣教和推广。Objective:To investigate the situation and influencing factors of prophylactic drug use among highrisk population of atherosclerotic cardiovascular disease(ASCVD)in a community of Shanghai.Methods:From the chronic disease management platform of the Gumei Community Health Service Center in 2018,there were 1141 cases of ASCVD highrisk subjects(10-year cardiovascular disease risk 10%~15%)who were 60 years old and above with complete documentation and complete data.Among them,there were 496 males and 645 females,aged from 63 to 81 years old,with an average age of(72.4±4.7)years old.Through the electronic prescription system the drug treatment of this population in the past year was obtained.The relevant information was confirmed through telephone interview.Results:The proportion of taking antithrombotic drugs was 40.5%,and the proportion of people with diabetes,LDL-c up to standard and irregular exercise was higher(P<0.05).The proportion of statins taken was 43.5%,LDL-c compliance and irregular exercise group had a higher proportion of taking medication(P<0.05).Logistic regression analysis showed that LDL-c failure,smoking and regular exercise were the influencing factors of not taking antithrombotic drugs(P<0.05);LDL-c failure and regular exercise were the influencing factors of not taking statins(P<0.05).Conclusion:The low proportion of antithrombotic drugs and statins used in community ASCVD high-risk populations is related to LDL-c failure and exercise habits.It is necessary to further strengthen the propaganda and promotion of preventive drug use.

关 键 词：动脉粥样硬化性血管疾病 高危人群 指南导向药物治疗 调查 

分 类 号：R714.252[医药卫生—妇产科学]