安徽省冠心病和缺血性脑卒中二级预防用药的现况调查  

Status of secondary preventive drugs for coronary heart disease and ischemic stroke in Anhui province

作　　者：袁芳 赵婵娜 郑丽梅 潘海峰[3] YUAN Fang;ZHAO Channa;ZHENG Limei;PAN Haifeng(Anhui Institute of Cardiovascular Disease,the First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China;不详)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院),安徽省心血管病研究所,心血管内科,合肥230001 [2]中国科学技术大学附属第一医院(安徽省立医院),心血管内科,合肥230001 [3]安徽医科大学公共卫生学院流行病与卫生统计学系

出　　处：《中国临床保健杂志》2024年第5期626-630,共5页Chinese Journal of Clinical Healthcare

基　　金：中央补助重大项目资金资助项目(皖财社〔2023〕26号,皖财社〔2023〕827号)。

摘　　要：目的调查安徽省冠心病和缺血性脑卒中患者二级预防用药情况,及与个体特征的相关关系。方法问卷调查安徽省15个县/区的145543例35~75岁的常住居民,自报冠心病和缺血性脑卒中患病情况和相关药物使用情况,并采用单变量因素和多变量混合效应模型分析其相关关系。结果自报患有冠心病或缺血性脑卒中的有3636例,患病率为2.49%。单因素回归分析显示,服用抗血小板药物或他汀类药物的患者中,男性、城市、非农民和高收入人群的药物使用率高于女性、农村、农民和低收入人群;超重和肥胖增加了服用二级药物风险,差异有统计学意义。多因素回归分析显示,女性(OR=0.69,95%CI:0.56~0.84,P<0.05)、农民(OR=0.39,95%CI:0.32~0.48,P<0.05)抗血小板药或他汀类药物的服用可能性低,而城市(OR=1.50,95%CI:1.24~1.81,P<0.05)、高中以上(OR=1.36,95%CI:1.05~1.77,P=0.021)和高血压患者(OR=1.56,95%CI:1.28~1.91,P<0.05)的药物使用可能性高。结论安徽省冠心病和缺血性脑卒中患者二级预防药物使用率较低,可针对低靶点人群采取干预措施,增强心血管疾病人群二级预防的药物依从性。Objective To investigate the use of secondary preventive medication in patients with coronary heart disease and ischemic stroke in Anhui Province,and its correlation with individual characteristics.Methods There were 145543 permanent residents aged 35-75 years old from 15 counties/districts in Anhui Province,who were selected and the coronary heart disease and ischemic stroke and related drug use were collected through a questionnaire survey.Univariable and multivariable mixed models were used to analyze the correlation.Results There were 3636 patients(2.49%)with coronary heart disease or ischemic stroke among the participants.In univariable regression analysis,the drug use rate was higher in male,urban,non-agricultural and high-income groups than in female,rural,farmer and low-income groups among patients taking antiplatelet drugs or statins.Being overweight and obese increased the risk of secondary prevention therapies,and the difference was statistically significant.Multivariable regression analysis showed that women(OR=0.69,95%CI:0.56-0.84,P<0.05)and farmers(OR=0.39,95%CI:0.32-0.48,P<0.05)were less likely to take antiplatelet drugs or statins;cities(OR=1.50,95%CI:1.24-1.81,P<0.05),high school education or above(OR=1.36,95%CI:1.05-1.77,P=0.021)and hypertension(OR=1.56,95%CI:1.28-1.91,P<0.05)were more likely to use drugs.Conclusions The utilization rate of secondary preventive drugs in reported patients with coronary heart disease and ischemic stroke is lower in Anhui province,and targeted interventions can be taken to improve compliance with secondary preventive drug therapy in patients with cardiovascular diseases.

关 键 词：冠心病 卒中 二级预防 血小板聚集抑制剂 羟甲基戊二酰基COA还原酶抑制剂 调查和问卷 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R541.4[医药卫生—临床医学]