缺血性脑血管病二级预防他汀类药物应用现况调查

目的:了解北京市部分二级医院缺血性脑血管病二级预防他汀类药物应用现状,为改进缺血性脑血管病二级预防工作提供依据。方法:本研究为现况调查,研究对象为北京市4家二级医院中诊断为急性动脉粥样硬化性脑梗死及短暂性脑缺血发作(TIA)的住院患者,调查患者住院期间以及出院3个月他汀类药物的应用现况。结果:入选患者共458例,其中408例完成了3月随访。住院期间他汀类药物的应用比率为35.6%;出院3月,他汀类药物的用药比率降为22.3%,与住院期间相比有明显差异(p<0.001);而依从性差的原因与患者的性别、经济负担、学历、危险因素的存在与否及脑血管病亚型(脑梗死或TIA)均无明显相关。3月随访发现缺血性脑血管事件发生率为4.9%(20例),冠脉综合征0.5%(2例),且22例血管事件复发患者中仅有9.1%(2例)坚持他汀治疗。结论:北京市部分二级医院脑血管病医生对他汀类调脂药用于缺血性脑血管病二级预防已经有了一定程度的认识,但与卒中降脂指南尚有距离,同时我们应对缺血性脑血管病患者他汀用于缺血性脑血管病二级预防的依从性给予关注。

The cross-sectional study on the status of statins using in secondary Prevention of cerebral ischemia

Objective：To investigate the status of statin using in secondary prevention of atherosclerotic cerebral ischemia and to provide clues for improving the secondary prevention.Methods：The study was a crosssectional investigation.All inpatients with diagnosis of atherosclerotic cerebral infarction or TIA（transient ischemia attack） from four second class hospitals in Bejing were recruited.The status of statins using in secondary prevention of cerebral ischemia during hospitalization and at 3-month after discharging were investigated.Results：458 patients met the recruiting criteria,and 408 of them got a 3-month follow up.the using proportion of statin agents was 35.7% during hospitalization and 22.3% at 3-month follow up.showing a bad compliance.Sex、economic burden、education、risk factors of cerebral ischemia and the type of cerebral vascular disease were not associated with the bad compliance of statin agents.The rate of recurrent cerebral ischemia and cardiovascular disease were 4.9%（22 patients） and 0.5%（2 patients） at 3-month after discharging.Only 9.1%（2 patients） of them were still treated with statins.Conclusion：The status of statins using in secondary prevention on cerebral ischemia in second class hospitals in Beijing were not optimistic.We should pay more attention to the compliance with statins in secondary prevention of cerebral ischemia.