甘肃农村地区冠心病患者PCI术后1年服药情况调查

目的评价甘肃农村地区冠心病患者经皮冠状动脉介入术(PCI)后1年的服药情况,分析其影响因素及对其预后的影响。方法选择2018年1月至12月于甘肃省人民医院行PCI术的农村地区冠状动脉粥样硬化性心脏病(冠心病)患者442例,术后6、12月分别进行电话联合微信平台问卷的方式随访,了解患者服药情况以及对其预后的影响。结果442例患者中非规律服药者232例(52.5%)。非规律服药者男性多于女性、老年人多于中青年人、支架植入数量少者多于数量多者(P<0.05),陈旧性心肌梗死、住院费用越高者非规律服药率较高(P<0.05)。术后6月阿司匹林片、氯吡格雷、替格瑞洛、他汀、β受体阻滞剂、ACEI/ARB的服用率分别为87.1%、82.6%、71.9%、64.0%、45.0%;术后12月为71.9%、53.8%、49.1%、40.9%、25.3%。非规律服药较规律服药人群支架通畅率减低、冠心病症状增多及射血分数下降(P<0.05),死亡人群无差异性(P>0.05)。多元logistic回归分析显示:年龄、性别、合并基础疾病(高血压、糖尿病、高脂血症)、支架数量为服药行为的独立影响因素。结论甘肃农村地区PCI后1年规律服药情况较差,预后相应不佳。

Investigation on medication status of patients with coronary heart disease in rural areas of Gansu for one year after PCI

Objective To evaluate the medication status of patients with coronary heart disease in rural areas of Gansu in 1 year after percutaneous coronary intervention(PCI),and to analyze the influencing factors and their prognosis.Methods A total of 442 patients with coronary heart disease who underwent PCI in Gansu Provincial People’s Hospital from January to December 2018 were selected.They were followed up by telephone and WeChat platform questionnaires at 6 and 12 months after surgery to understand the patient’s medication status and their prognosis influences.Results Among the 442 patients,232(52.5%)were taking medication irregularly.More men than women take irregular medications,more elderly than young and middle-aged persons,less stent implantation more than more stents(P<0.05),older myocardial infarction,higher hospitalization costs,higher rates of irregular medication(P<0.05).The taking rates of aspirin tablets,clopidogrel,ticagrelor,statins,β-blockers,and ACEI/ARB in 6 months after surgery were 87.1%,82.6%,71.9%,64.0%,and 45.0%,respectively.After 12 months,the rates were 71.9%,53.8%,49.1%,40.9%,and 25.3%.Compared with the regular medication,the stent patency rate was reduced,the coronary heart disease symptoms increased,and the ejection fraction decreased(P<0.05)among the people who took the medication irregularly(P>0.05).There was no difference in the death population(P>0.05).Multivariate logistic regression analysis showed that age,gender,combined underlying diseases(hypertension,diabetes,hyperlipidemia),and the number of stents were independent factors influencing medication behavior.Conclusion The 1-year regular medication situation after PCI in rural areas of Gansu is poor,and the prognosis is correspondingly poor.