急性脑梗死二级预防药物依从性与出院一年预后的相关性研究  

Correlation of compliance with secondary prophylactic drugs and one-year prognosis in patients with acute cerebral infarction

作　　者：徐丽华 张广波 于凯 杨红娜 何艳 冀瑞俊[3] 王拥军[3] Xu Lihua;Zhang Guangbo;Yu Kai;Yang Hongna;He Yan;Ji Ruijun;Wang Yongjun(Department of Neurology,Renqiu Kangjixintu Hospital,Renqiu 062550,China)

机构地区：[1]任丘康济新图医院神经内科,062550 [2]任丘康济新图医院内分泌科,062550 [3]首都医科大学附属北京天坛医院神经内科

出　　处：《北京医学》2022年第2期114-118,共5页Beijing Medical Journal

基　　金：2021年度河北省医学科学研究课题计划(20211275)。

摘　　要：目的探讨急性脑梗死患者二级预防药物依从性与出院1年预后的关系。方法选取2014年1月至2018年8月任丘康济新图医院收治的急性脑梗死患者3302例,登记患者基本信息、临床资料、实验室检查及影像学资料等,在患者出院1年时进行电话随访,按随访时临床结局改良Rankin量表(modified Rankin scale,mRS)评分分为预后良好组(m RS评分≤2分,3067例)和预后不良组(mRS评分>2分,235例),采用多因素logistic回归分析急性脑梗死患者二级预防药物依从性与出院1年预后不良之间的关系。结果急性脑梗死患者预后不良组与预后良好组性别、年龄、婚姻状态、文化程度、高脂血症史、卒中史、心房颤动史、外周血管疾病史、吸烟、过量饮酒、二级预防药物依从性、SBP、胱抑素C、RBC、红细胞比容、Hb、PT、INR、FIB、同型半胱氨酸和入院24 h内美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分比较,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,急性脑梗死患者1年预后不良的独立危险因素为年龄大(OR=1.052,95%CI:1.037~1.068,P=0.000)、卒中史(OR=1.568,95%CI:1.159~2.120,P=0.004)、二级预防药物依从性差(OR=0.642,95%CI:0.473~0.873,P=0.005)、SBP高(OR=1.008,95%CI:1.002~1.014,P=0.007)和入院24 h内NIHSS评分高(OR=1.371,95%CI:1.315~1.429,P=0.000)。通过年龄、二级预防药物依从性、卒中史、SBP和入院24 h内NIHSS评分可联合预测脑梗死1年预后不良,AUC为0.836。结论急性脑梗死患者二级预防药物依从性差可增加1年不良预后的风险,提高患者二级预防药物依从性,可降低不良预后的发生。Objective To investigate the relationship between the compliance of secondary prophylactic drugs and oneyear prognosis in patients with acute cerebral infarction(ACI). Methods According to the research database of Acute Intervention and Secondary Prevention of Ischemic Stroke in the Department of Neurology of Renqiu Kangjixintu Hospital, a total of 3 302 patients with ACI admitted from January 20, 2014 to August 22, 2018 were consecutively enrolled. Basic information, clinical data, laboratory examination and image data of the patients were collected. Telephone follow-up was performed one year after discharge. The patients were grouped according to the clinical outcome of the one-year follow-up with the modified Rankin scale(m Rs). There were 3 067 patients in the good prognosis group(mRs score ≤ 2) and 235patients in the poor prognosis group(mRs score>2). Multivariate logistic regression was used to analyze the relationship between the compliance with secondary prophylactic drugs and poor prognosis one year after discharge in the patients with ACI. Results There were significant differences between the two groups in gender, age, marital status, educational level,history of hyperlipidemia, history of stroke, history of atrial fibrillation, history of peripheral vascular disease, smoking,excessive drinking, compliance with secondary prophylactic drugs, SBP, cystatin C, RBC, hematocrit, Hb, PT and INR, FIB,homocysteine and the National Institutes of Health Stroke Scale(NIHSS) scores within 24 h of admission to hospital(P<0.05). Multivariate logistic regression analysis showed that old age(OR = 1.052, 95%CI:1.037-1.068, P = 0.000), history of stroke(OR = 1.568, 95%CI:1.159-2.120, P = 0.004), poor compliance with secondary prophylactic drugs(OR = 0.642, 95%CI:0.473-0.873, P = 0.005), high SBP(OR = 1.008, 95%CI:1.002-1.014, P = 0.007), and high NIHSS score within 24 hours of admission(OR = 1.371, 95% CI:1.315-1.429, P = 0.000) were independent risk factors of poor prognosis of one-year in patients with ACI. Age, com

关 键 词：急性脑梗死 二级预防药物 依从性 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]