内蒙古包头地区40岁及以上人群抗血小板聚集类药物使用现状及影响因素的真实世界研究  

Real World Study on the Current Status and Influencing Factors of Antiplatelet Aggregation Drugs Use among People Aged 40 and above in Baotou,Inner Mongolia

作　　者：于文龙 白茹玉 禹延雪 郭霞[1] 吴丽娥[1] YU Wenlong;BAI Ruyu;YU Yanxue;GUO Xia;WU Lie(Department of Neurology,the First Affiliated Hospital of Baotou Medical College,Baotou 014010,China)

机构地区：[1]包头医学院第一附属医院神经内科,包头014010

出　　处：《中国卒中杂志》2023年第6期651-659,共9页Chinese Journal of Stroke

摘　　要：目的明确真实世界内蒙古包头地区40岁及以上人群抗血小板聚集类药物的使用情况,以及不同人群服药率的影响因素。方法采用以居委会、村委会为单位的多级、整群、随机抽样方法,在2021年6月—2022年9月抽取包头地区40岁及以上常住居民。采用调查问卷形式收集研究对象的一般资料、既往病史及抗血小板聚集类药物使用情况。按照是否有心脑血管疾病(cardio cerebrovascular diseases,CVD)以及是否存在CVD危险因素将研究对象分为3组:CVD组(既往患CVD人群)、CVD危险因素组(无CVD病史,有以下1个或多个CVD危险因素:高血压、糖尿病、高血脂、吸烟史、饮酒史、肥胖)、健康对照组(无CVD病史,无CVD危险因素)。比较3组间一般资料的差异。根据是否服用抗血小板聚集类药物,将CVD组和CVD危险因素组的研究对象分别分为服药组和未服药组,采用单因素和多因素分析调查两组中影响服药的相关因素。结果①研究共纳入2100例有效调查对象,其中CVD组298例(14.2%)、CVD危险因素组1040例(49.5%)、健康对照组762例(36.3%)。3组人群中抗血小板聚集类药物应用率分别为51.68%(154例)、33.46%(348例)和6.69%(51例),组间差异有统计学意义(P<0.001)。②多因素分析显示,CVD组中较高学历(以小学及以下学历为基线,高中OR 2.429,95%CI 1.277~4.619,P=0.007、本科及以上学历OR 8.500,95%CI 1.015~12.165,P=0.048)以及合并糖尿病(OR 2.820,95%CI 1.377~5.777,P=0.005)的患者更倾向于应用抗血小板聚集类药物;CVD危险因素组中抗血小板聚集类药物应用率受个人经济收入(以<1.0万/年为基线,>5.0万/年OR 18.547,95%CI 8.948~38.444,P<0.001)、学历(以小学及以下学历为基线,本科及以上学历OR5.512,95%CI1.736~17.495,P=0.004)、吸烟史(OR0.712,95%CI0.541~0.936,P=0.015)、BMI(与低BMI患者相比,BMI正常OR5.640,95%CI1.172~27.144,P=0.031);肥胖(OR8.440,95%CI1.684~42.293,P=0.009)、患高血压(OR246.029,95%CI1Objective To clarify the use of antiplatelet aggregating drugs in people aged 40 years and above in Baotou area of Inner Mongolia in the real world,and the factors influencing the rate of taking drugs in different populations.Methods A multilevel,whole-group,random sampling method with neighborhood and village committees was used to draw permanent residents aged 40 years and above in Baotou area from June 2021 to September 2022.A questionnaire was used to collect general information,past medical history and the use of anti-platelet aggregating drugs from the study population.The subjects were divided into three groups according to the presence or absence of cardio cerebrovascular diseases(CVD)and the presence of CVD risk factors:CVD group(with previous CVD),CVD risk factor group(no history of CVD,with one or more of the following CVD risk factors:hypertension,diabetes mellitus,hyperlipidemia,history of smoking,history of alcohol consumption,obesity),the healthy control group(no history of CVD,no risk factors for CVD).The differences in general information between the 3 groups were compared.The subjects in the CVD group and the CVD risk factor group were divided into the medication group and the non-medication group according to whether they were taking antiplatelet aggregation drugs or not,and the relevant factors affecting medication taking in the two groups were investigated using univariate and multifactorial analyses.Results①A total of 2100 validated subjects were included in the study,including 298 cases(14.2%)in the CVD group,1040 cases(49.5%)in the CVD risk factor group,and 762 cases(36.3%)in the healthy control group.The rates of taking antiplatelet aggregation drugs in the three groups were 51.68%(154 cases),33.46%(348 cases),and 6.69%(51 cases),respectively,with statistically significant differences between groups(P<0.001).②Multifactorial analysis showed that higher education(primary school education or less as the baseline,high school OR2.429,95%CI 1.277-4.619,P=0.007,undergraduate education or abo

关 键 词：抗血小板聚集类药物 心脑血管疾病 一级预防 二级预防 

分 类 号：R969.3[医药卫生—药理学]