定期电话随访对缺血性脑卒中患者二级预防的影响

The influence of follow-up by phone on secondary prevention of ischemic stroke

目的探讨定期电话随访对缺血性脑卒中患者二级预防措施有效实施的影响。方法选取缺血性脑卒中患者116例,均遵照缺血性卒中诊疗指南进行急性期治疗和二级预防药物治疗(包括抗栓、调脂、降压,降糖,口服尼莫地平等)。对照组患者出院后不进行电话随访;干预组患者出院后定期电话随访。所有患者1年后复查血糖、血脂、血压,进行认知功能评分(CDR评分和MoCA评分),记录卒中复发情况和服药依从性情况。结果干预组患者血压、血糖、血脂达标率及服药依从性明显高于对照组(P<0.05)。干预组患者血管性认知功能障碍改善(MoCA各项评分均较前提高,CDR评分无进展为临床痴呆病例);而对照组有4例患者进展为轻度认知功能障碍,占总数的8.5%(4/47),且有1例患者进展为临床痴呆,占总数的9.0%(1/11)。结论对缺血性卒中患者定期电话随访,可提高其服药依从性,是充分实施卒中二级预防的有效措施之一。

Objective To investigate the influence of telephone follow-up regularly on Secondary prevention of ischemic stroke.Methods 116 patients with ischemic stroke were selected.All patients were treated with evidence-based therapy,including acute stages treated and secondary prevention of ischemic stroke（including antithrombotic treatment,blood lipid regulation,antihypertensive therapy,glucose-lowering treatment,oral nimodipine,et al）.The patients of control group were not followed-up after discharge,while those of intervention group were telephone follow-up regularly.After 1 year,glucose,blood pressure and plasma lipid were assay in all patients.The cognitive function were assessed also,including CDR and MoCA.The rate of ischemic stroke recurrence and drug compliance were recorded.Results The standard-reaching rate of glucose,blood pressure and plasma lipid higher than that in control group（P〈0.05）,as well as the drug compliance.The vascular cognitive impairmen get better in patients of intervention group,while get worse in patients of control group.The rate of mild cognitive impairment and vascular dementia in patients of control group was 8.5%（4/47）and 9.0%（1/11）.Conclusion Following-up regularly to patients with ischemic stroke can improve the drug compliance and the quality of secondary prevention of ischemic stroke.