心绞痛患者应用辛伐他汀治疗的依从性研究

背景:他汀类药物在冠心病一、二级预防中的作用已经得到了广泛认同,通过其降脂和非降脂作用,可显著改善不同胆固醇水平个体的预后。他汀类的收益依赖于药物的长期不间断治疗。目的:通过对平均胆固醇水平不稳定性心绞痛患者辛伐他汀治疗依从性及影响因素调查,分析治疗依从性的现状及相关因素,为提高药物的干预率提供依据。方法:选择平均胆固醇水平不稳定性心绞痛患者,口服辛伐他汀作为二级预防手段,随访药物治疗的依从情况、药物不良反应,分析不依从治疗的原因。结果:辛伐他汀治疗3、6、18个月的依从性分别是68.9%、48.0%,40.0%,依从性下降以前6个月明显。不稳定性心绞痛的临床分型和患者的年龄群对治疗依从性影响不大,高危患者治疗的依从性低。不依从治疗的主要原因有患者对高危人群血脂控制水平、他汀类药物的非降脂作用认识不足,以及经济条件限制等。结论:辛伐他汀在冠心病二级预防中的治疗依从性较低,为提高远期疗效,有必要提高患者对药物治疗的依从性。

Compliance of angina patients to simvastatin therapy

Background: The roles of statins on first or second prevention of coronary heart disease by lipid-lowering or non-lipid-lowering effects were widely identified. Statins can improve prognosis of patients with various cholesterol levels-which is relied on long-term continuing therapy. Objective: By analyzing appearance of simvastatin therapy compliance and its affecting factors-the study would supply evidence for promotion of statins intervention. Methods: Unstable angina patients with average cholesterol levels were chosen to receive simvastatin for secondary prevention of coronary heart disease. The therapy compliance-drug adverse reactions and reasons of non-compliance were investigated and followed up. Results:The simvastatin therapy compliance in 3-6-and 18 months was respectively 68.9%-48.0%-40.0%-with a significant lowering in the first 6 months. The clinic types of unstable angina and patient's age showed no influence on therapy compliance-but compliance of high-risk patients was in a low level. The causes of non-compliance were dut to patient's poor knowledge for lipid control levels in high-risk condition and non-lipid-lowerigng effect of statins-and consideration of financial burden-etc. Conclusion: In second prevention of cardiovascular events with simvastatin in unstable patients with average cholesterol levels-there is a low level of therapy compliance. It is very important for physicians to improve compliance of patients for statins therapy.