缺血性脑卒中二级预防药物治疗依从性研究

目的 了解缺血性脑卒中患者二级预防药物依从情况,为卒中二级预防工作的实施提供依据.方法 前瞻性地连续纳入乌鲁木齐地区缺血性卒中患者242例,记录患者从住院开始到出院12个月内的服药情况、停药原因.结果 缺血性脑卒中患者出院12个月时抗血栓药物服用率为55.8%(135/242),民族(OR=4.007,95%CI=1.768~9.080)、文化程度(OR=2.953,95%CI=1.493~5.840)、支付方式(OR=0.189,95%CI=0.060~0.594)、血脂异常病史(OR=0.424,95%CI=0.217~0.831)与依从性相关.患者在出院12个月时调脂药物的服用率为59.9%(145/242),文化程度(OR=3.613,95%CI=1.844~7.082)、支付方式(OR=0.254,95%CI=0.091~0.711)、血脂异常病史(OR=0.340,95%CI=0.179~0.648)与依从性相关.合并高血压病患者在出院12个月时降压药的服用率为71.9%(138/192),合并糖尿病患者出院12个月降糖药物的服药率为64.8%(59/91).抗血栓药物、调脂药物依从性差主要原因为症状改善停药、认为无须服药等.降压药物、降糖药物依从性差原因主要为检查指标好转、认为无须服药等.结论 缺血性脑卒中患者二级预防药物依从性普遍偏低,提醒临床医生应对患者的二级预防用药加强指引作用.

Treatment compliance in secondary prevention of ischemic stroke

Objective To investigate the status of medicine compliance in secondary prevention of ischemic stroke, in order to provide evidence for the secondary prevention.Methods Data of 242 con-tinuous ischemic stroke patients in Urumqi were prospectively collected. Information of medicine and reasons of ceasing durgs was registered in 12 months.Results The rate of taking antithrombotic drugs one year after discharged was 55.8%(135/242). The nationality(OR=4.007, 95%CI=1.768-9.080), degree of education(OR= 2.953, 95%CI=1.493-5.840), pattern of payment(OR=0.189, 95%CI=0.060-0.594), dyslipidemia(OR=0.424, 95%CI=0.217-0.831) were associated with treatment compliance one year after discharged. The rate of taking stains one year after discharged was 59.9%(145/242). The degree of education(OR=3.613, 95%CI=1.844-7.082), pattern of payment(OR=0.254, 95%CI=0.091-0.711), dyslipidemia(OR=0.340, 95%CI=0.179-0.648) were associated with compliance of medicine one year after discharged. The rates of taking hypotensor and hy-poglycemic agent one year after discharged were 71.9%(138/192) and 64.8%(59/91). The main reasons of poor compliance of antithrombotic drugs and stains were symptoms improved and ignoring the treatment. The main reasons of poor compliance of hypotensor and hypoglycemic agent were indicators improved and ignoring the treatment.Conclusions The treatment compliance in secondary prevention of ischemic stroke patients is gen-erally poor. The clinicians should focus on the secondary prevention guidance.