缺血性脑血管病二级预防药物依从性及其影响因素研究  

Drug Adherence and Influencing Factors in Secondary Prevention of Ischemic Cerebrovascular Disease

作　　者：杨红娜 冀瑞俊[2] 于凯 何艳 徐丽华 王拥军[2] YANG Hongna;JI Ruijun;YU Kai;HE Yan;XU Lihua;WANG Yongjun(Department of Neurology,Kangjixintu Hospital,Renqiu 062550,China;Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]任丘康济新图医院神经科,任丘062550 [2]首都医科大学附属北京天坛医院神经病学中心

出　　处：《中国卒中杂志》2022年第11期1227-1232,共6页Chinese Journal of Stroke

基　　金：2021年度河北省医学科学研究课题计划(20211275)。

摘　　要：目的探索缺血性脑血管病患者出院后3个月二级预防药物依从性及其影响因素。方法选取2014年1月-2018年11月任丘康济新图医院神经内科住院的急性脑梗死和TIA患者,调查其住院期间及出院后3个月服用二级预防药物的依从性,采用多因素logistic回归分析出院后3个月患者药物依从性的影响因素。结果4151例入组患者中,3个月随访时二级预防药物总体依从性为78.8%,在二级预防药物种类中依从性分别为抗血小板药物89.3%、降压药物87.5%、降脂药物86.9%、降糖药物79.3%、抗凝药物56.0%。多因素logistic回归分析显示,已婚(OR 1.589,95%CI 1.304~1.936,P<0.001)、卒中病史(OR 1.225,95%CI 1.037~1.447,P=0.017)、糖尿病病史(OR 0.570,95%CI 0.463~0.701,P<0.001)、发病前抗凝药物使用(OR 0.192,95%CI 0.060~0.619,P=0.006)、出院时二级预防药物种类数(OR 0.841,95%CI 0.736~0.960,P=0.010)为二级预防药物依从性的独立影响因素。结论已婚、卒中病史、糖尿病病史、发病前抗凝药物使用及出院时二级预防药物种类数是二级预防药物依从性的独立影响因素。Objective To analyze the adherence of secondary prevention drugs within 3 months after discharge and related influencing factors in patients with ischemic cerebrovascular disease.Methods The patients with acute cerebral infarction and TIA hospitalized in Department of Neurology of Renqiu Kangji Xintu Hospital from January 2014 to November 2018 were included in the retrospective analysis.The adherence of drugs during hospitalization and 3 months after discharge were analyzed.Multivariate logistic regression analysis was used to determine the influencing factors of drug adherence.Results A total of 4151 patients were included in this study.The total adherence rate of secondary prevention drugs at 3 months after discharge was 78.8%,and that of all kinds of secondary prevention drugs were as follows:antiplatelet drugs was 89.3%,antihypertensive drugs was 87.5%,lipid-lowering drugs was 86.9%and hypoglycemic drugs was 79.3%and anticoagulants was 56.0%.Multivariate logistic regression analysis showed that being married(OR 1.589,95%CI 1.304-1.936,P<0.001),history of stroke(OR 1.225,95%CI 1.037-1.447,P=0.017),history of diabetes(OR 0.570,95%CI 0.463-0.701,P<0.001)and anticoagulant drug use before stroke or TIA onset(OR 0.192,95%CI 0.060-0.619,P=0.006),number of drug kinds prescribed at discharge(OR 0.841,95%CI 0.736-0.960,P=0.010)were independent influencing factors of drug adherence.Conclusions Being married,history of stroke,history of diabetes,use of anticoagulants before stroke or TIA onset and number of drug kinds prescribed at discharge were independent influencing factors of secondary prevention drug adherence for patients with ischemic stroke or TIA.

关 键 词：缺血性脑血管病 药物依从性 二级预防 

分 类 号：R743.3[医药卫生—神经病学与精神病学]