冠心病患者PCI术后β受体阻滞剂用药依从性下降的危险因素分析  

Analysis of risk factors for decreased medication compliance ofβreceptor blocker in patients with coronary heart disease after PCI

作　　者：侯晓鑫 郝俊霞 张晓敏 HOU Xiao-xin;HAO Jun-xia;ZHANG Xiao-min(CCU of Department of Cardiology,First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,075000,China)

机构地区：[1]河北北方学院附属第一医院心内科CCU,河北张家口075000

出　　处：《心血管康复医学杂志》2024年第3期285-289,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：2018年度河北省医学科学研究重点课题(20180866)。

摘　　要：目的:研究冠心病(CHD)患者经皮冠状动脉介入(PCI)术后β受体阻滞剂用药依从性下降的危险因素。方法:选择2020年1月至2021年7月期间本院收治的160例行PCI治疗的CHD患者。术后根据Morisky用药依从性量表(MMAS-8)评分,≥6分者纳入高依从性组(100例),<6分者纳入低依从性组(60例)。采用单因素和多因素Logistic回归分析CHD患者PCI术后β受体阻滞剂用药依从性降低的影响因素。结果:160例患者的平均MMAS-8评分为(5.81±0.12)分。与高依从性组比较,低依从性组年龄<60岁(74.00%比36.67%)、高中及以上(68.00%比40.00%)、支架植入<2年(54.00%比28.33%)比例、家庭关怀指数调查问卷(APGAR)评分[(5.12±1.60)分比(4.52±2.10)分]、APGAR评分≥7分比例(68.00%比33.33%)显著降低,家庭收入<3000元(34.00%比61.67%)、自费(36.00%比60.00%)、糖尿病(47.00%比66.67%)和高血压(42.00%比65.00%)比例显著升高,P<0.05或<0.01。多因素Logistic回归分析显示初中文化程度、年龄≥60岁、家庭收入<3000元、自费、支架植入时间≥2年、高血压、糖尿病是CHD患者PCI术后β受体阻滞剂用药依从性下降的独立危险因素(OR=8.445~97725.056,P<0.05或<0.01),而APGAR评分≥7分为其独立保护因素(OR=0.005,P=0.001)。结论:CHD患者PCI术后的β受体阻滞剂用药依从性降低的影响因素包括年龄、支架植入时间、文化程度等,应该重点监督存在危险因素患者的用药情况并给予干预,有助于提升用药依从性。Objective:To investigate the risk factors of decreased medication compliance ofβ-receptor blocker in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:A total of 160 CHD patients undergoing PCI from January 2020 to July 2021 in our hospital were selected.According to postoperative Morisky medication adherence scale(MMAS-8)score,they were divided into high compliance group(n=100,≥6 points)and low compliance group(n=60,<6 points).Univariate and multivariate Logistic regression analysis were conducted to analyze the influencing factors of decreased medication compliance ofβ-receptor blocker in CHD patients after PCI.Results:The mean MMAS-8 score of 160 patients was(5.81±0.12)points.Compared with high compliance group,there were significant reductions in percentages of age<60 years(74.00%vs.36.67%),high school or higher education(68.00%vs.40.00%),stent implanted duration<2 years(54.00%vs.28.33%),family APGAR index score[(5.12±1.60)points vs.(4.52±2.10)points],proportion of APGAR score≥7 points(68.00%vs.33.33%),and significant rise in percentages of family income<3000 RMB(34.00%vs.61.67%),self-paying(36.00%vs.60.00%),diabetes(47.00%vs.66.67%)and hypertension(42.00%vs.65.00%)in low compliance group,P<0.05 or<0.01.Multivariate Logistic regression analysis indicated that junior high school education,age≥60 years,family income<3000 RMB,self-paying,stent implanted duration≥2 years,hypertension and diabetes were independent risk factors for decreased medication compliance ofβ-receptor blocker in CHD patients after PCI(OR=8.445~97725.056,P<0.05 or<0.01),while APGAR score≥7 points was its independent protective factor(OR=0.005,P=0.001).Conclusion:The influencing factors for decreased medication compliance ofβ-receptor blocker in CHD patients after PCI include age,stent implanted duration,education level etc.It is necessary to focus on monitoring the medication of patients with risk factors and perform intervention,which is helpful to improve medication compliance.

关 键 词：冠心病 血管成形术 气囊 冠状动脉 肾上腺素能Β受体拮抗剂 服药依从性 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]