缺血性脑卒中二级预防治疗的依从性研究

目的采取有效措施减少缺血性脑卒中再发,对缺血性脑卒中或短暂性脑缺血发作(TIA)患者采取ABCDE策略,观察患者出院后1年能否维持高水平药物治疗符合率。方法选择缺血性脑卒中或TIA患者178例,采取ABcDE策略进行规范的二级预防。观察患者出院时及出院后1年二级预防中抗血小板、降压、降糖和他汀类药物治疗的符合率。结果 178例患者中既往有缺血性脑卒中或TIA史126例,其住院前抗血小板治疗比例为41.3%,服用降压、降糖和他汀类药物治疗比例分别为89.9%、83.3%和13.5%;155例完成出院1年随访,降压治疗符合率为100%,抗血小板治疗符合率为97.2%,降糖和他汀类药物治疗符合率为98.2%和84.3%。结论采取ABCDE策略对缺血性脑卒中或TIA患者进行规范干预后,明显缩小二级预防循证证据与临床实践之间的差距,患者出院1年药物治疗符合率维持在较高水平。

Study of compliance with secondary prevention of ischemic stroke

Objective To determine whether adopting ABCDE strategy can maintain medication conforming rate at high level at 1 year after discharge from hospital. Methods A total of 178 patients with ischemic stroke or TIA who had been admitted to Anzhen Hospital were given standardized stroke secondary prevention adopting ABCDE strategy. The conforming rates of antiplatelet, antihypertension,antidiabetic and lipid-lowering therapy in the patients at the time of and 1 year after discharge from hospital were analyzed. Results Of the 178 patients with ischemic stroke or TIA, 126 had previous ischemie stroke or TIA history. The rate of antiplatelet treatment before their hospitalization was 41.3%, and antihypertension, antidiabetic and lipid-lowering therapy rates were 89.9%,83.3% and 13.5% respectively. In 155 patients at 1 year after discharge, the rates of antiplatelet, antihypertension, antidiabetic and lipid lowering therapy were 97.2%, 100%,98.2% and 84.3%. Conclusion After adopting ABCDE strategy to standardize intervention of ischemic stroke/TIA patients, the gap between evidence-based medicine and clinical practice of the secondary prevention was significantly narrowed. The medication conforming rates was maintained at a relatively high level at 1 year after discharge from hospital.