社区就诊血栓栓塞性疾病患者阿司匹林抗栓治疗情况分析

目的:了解阿司匹林在社区血栓栓塞性疾病二级预防实践中的应用,评价阿司匹林应用中存在的问题和影响因素。方法:研究为横断面调查,2013年8月至2013年9月在北京10城区各选择1所社区卫生服务中心。通过问卷调查,收集1个月内到社区就诊的具有血栓栓塞性疾病的患者抗栓治疗信息。结果:共收集研究对象465例,男性281例(60.4%),女性184(39.6%)。年龄30~89岁,平均年龄(64.5±10.3)岁。冠心病患者170例(36.6%),缺血性脑卒中患者159例(34.2%),同时伴有冠心病和缺血性脑血管病患者77例(16.6%)。阿司匹林服用例数为377例(81.1%),冠心病患者阿司匹林服用例数为143例(84.1%),缺血性脑卒中患者服用例数为137例(86.2%)。男性阿司匹服用率为84.3%(237例),女性为76.1%(140例),男性阿司匹林服用率高于女性(χ2=4.938,P=0.026)。就诊时317例处方阿司匹林,占总例数的68.2%,没有处方阿司匹林的患者中,60例(40.5%)因为尚有存药,45例(30.4%)因为禁忌症、或曾发生副作用而不适合用药。43例(29.1%)医生认为不需要服用。348例(98.6%)阿司匹林处方剂量为100mg。所有患者均服用阿司匹林肠溶片。318例对服药时间进行回答,165例(51.9%)餐前服药,153例(48.1%)餐后服药。结论:在社区就诊的血栓栓塞性疾病患者中阿司匹林的应用达到较高的水平,使用剂量合理。

Analysis on the use of Aspirin in patients with thromboembolism disease of communities in Beijing

Objective:To know the current status of aspirin use in patients with established thromboembolism disease,and evaluate what problem existing influence the utility of aspirin.Methods:A cross-section study was conducted in 10 community health centers located in 10 different districts in Beijing from August to September 2013.Patients' information about the situation of aspirin use was inquired face to face by general practitioners(GPs) and filled in the questionnaire.Results:In total of 456 patients,there were 281 males(60.4%) and 184 females(39.6%).Mean age was 64.5 ± 10.3.There were 170 patients with coronary heart disease(53.3%),159 patients with ischemic stroke(62.2%),and 77 patients both with coronary heart disease and ischemic cerebrovascular disease(16.6%).The overall utility rate of aspirin was 81.1%;it was 84.1% in coronary heart disease patients and 86.2% in ischemic stroke patients.Male had the higher utality rate of aspirin than the female did The utility rate of aspirin was higher in male than female,(84.3% in male,76.1% in female,χ2= 4.938,P = 0.026).317 patients(68.2%) were prescribed aspirin at that clinical visit.In patients without being prescribed aspirin,60 patients of them(40.5%) were because of having the rest of medicine,45 patients(30.4%) were not for using aspirin or warring about its side-effect,43 patients(29.1%) were considered not necessary for using aspirin by GPs.Three hundred and forty eight patients(98.6%) took aspirin with the dosage of 100mg per day.Three hundred and eighteen patients answered the question about the habit of using aspirin,165 patients(51.9%) of them took the medicine before male and 153 patients(48.1%) took the medicine after male.Conclusion:The rate of antithrombolic therapy was relative high in patients visiting the GPs normally,The rate of aspirin taking was higher in male than female.The dosage of aspirin was rational.But there were some problems in understanding the indications in general practitioners.