缺血性脑卒中二级预防药物依从性与疾病复发的关系研究  

Study on the correlation between adherence to secondary prevention drugs and disease recurrence in ischemic stroke

作　　者：叶明[1] 时鹏[1] 张丽娜[1] 许娟娟[1] 罗文平 YE Ming;SHI Peng;ZHANG Li-na(Department of Neurology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院神经内科,233004

出　　处：《中国实用医药》2024年第10期152-156,共5页China Practical Medicine

基　　金：蚌埠医学院人文社科重点项目(项目编号:2022byzd125sk),项目名称:社区缺血性脑卒中病人二级预防药物依从性的现状及影响因素分析。

摘　　要：目的本研究旨在探讨二级预防药物依从性现状及其与缺血性脑卒中复发之间的关系。方法200例缺血性脑卒中患者作为研究对象,收集其一般资料及相关指标,随访6个月,调查他汀类药物、抗血小板聚集药物等使用情况,采用Morisky用药依从性问卷(MMAS-8)分析药物依从性,并分析二级预防药物依从性与缺血性脑卒中复发的关系。结果收集患者200例,失访21例,纳入179例,其中伴高血压患者106例、2型糖尿病患者62例,他汀类药物依从性良好112例,占62.57%,依从性差67例,占37.43%;抗血小板聚集药物依从性良好126例,70.39%,依从性差53例,占29.61%;降压药物依从性良好59例,77.63%,依从性差17例,占22.37%;降糖药物依从性良好39例,占76.47%,依从性差12例,占23.53%。排除单纯降压药依从性差11例、降糖药物依从性差6例、同时两种药物依从性差6例,剩余156例患者中,他汀类药物依从性好患者101例,复发9例,占比8.91%;依从性差患者55例,复发17例,占比30.91%。他汀类药物依从性差患者的缺血性脑卒中复发率明显高于依从性良好患者,且具有显著差异(P<0.001)。抗血小板聚集药物依从性良好患者112例,复发7例,占比6.25%;依从性差患者44例,复发19例,占比43.18%。抗血小板聚集药物依从性差患者的缺血性脑卒中复发率明显高于依从性良好患者,且具有显著差异(P<0.001)。根据二级预防药物常见依从性差原因设置问题选项,结果显示检查指标正常后自行停药、症状改善后自行停药为主要原因,其次为经济原因、不良反应等。结论缺血性脑卒中患者存在药物使用依从性差的问题,且依从性越差,缺血性脑卒中复发率越高,表明缺血性脑卒中二级预防药物依从性与复发之间存在密切关联。Objective To explore the correlation between adherence to secondary prevention drugs and disease recurrence in ischemic stroke.Methods 200 patients with ischemic stroke were included as the research subjects.General data and related indicators were collected,followed up for 6 months to investigate the use of secondary preventive drugs and antiplatelet aggregation.Morisky medication adherence questionnaire(MMAS-8)was used to analyze drug compliance,and the correlation between adherence to secondary preventive drug and ischemic stroke recurrence was analyzed.Results A total of 200 patients were collected,21 cases were lost to follow-up,and 179 cases were included,including 106 patients with hypertension and 62 patients with type 2 diabetes mellitus.112 cases with good adherence to statins,accounting for 62.57%,and 67 cases with poor adherence,accounting for 37.43%;126 cases with good adherence to antiplatelet aggregation drugs,accounting for 70.39%,and 53 cases with poor adherence,accounting for 29.61%;59 cases with good adherence to antihypertensive drugs,accounting for 77.63%,and 17 cases with poor compliance,accounting for 22.37%;39 cases with good adherence to hypoglycemic drugs,accounting for 76.47%,and 12 cases with poor compliance,accounting for 23.53%.Excluding 11 cases of poor adherence to antihypertensive drugs alone,6 cases of poor adherence to hypoglycemic drugs,and 6 cases of poor adherence to both drugs,among the remaining 156 patients,there were 101 patients with good adherence to statins,with 9 cases of recurrence,accounting for 8.91%,and 55 patients with poor adherence,with 17 cases of recurrence,accounting for 30.91%.The recurrence rate of ischemic stroke in patients with poor adherence to statins was significantly higher than that in patients with good adherence,and there was a significant difference(P<0.001).There were 112 patients with good adherence to antiplatelet aggregation drugs,with 7 cases of recurrence,accounting for 6.25%;44 patients with poor adherence,with 19 cases of recurrence,acco

关 键 词：缺血性脑卒中 复发 二级预防药物依从性 关系 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R969.3[医药卫生—临床医学]