缺血性脑卒中患者二级预防用药依从性及其影响因素分析

Analysis on Second Grade Prevention Medication Compliance of Ischemic Stroke Patients and Its Influencing Factors

目的研究缺血性脑卒中患者二级预防用药依从性及其影响因素。方法选择北京军区总医院于2007年11月30日至2011年11月30日收治的缺血性脑卒中患者385例为研究对象,调查患者的性别、年龄、文化程度、医疗费用、医患关系、发病次数、对缺血性脑卒中及药物知识的了解程度、家庭收入,是否存在高血压、糖尿病、血脂异常、吸烟、饮酒、肥胖、体育活动减少等危险因素,并采用χ2检验和Logistic回归统计分析其对依从性的影响。结果患者不同的文化程度、医疗费用、医患关系、发病次数、对缺血性脑卒中及药物知识的了解程度、家庭收入、吸烟、饮酒、体育活动减少等危险因素对二级预防用药依从性有显著差异;依从性的好坏与文化程度、医疗费用、医患关系、对缺血性脑卒中及药物知识的了解程度、家庭收入呈正相关,与发病次数、吸烟、饮酒、体育活动减少呈负相关(P<0.05)。结论对于首次发病、存在吸烟、饮酒、体育活动减少的缺血性脑卒中患者应加以重视,因其用药依从性差,应更加注重对其随访和监督。

Objective To study the second grade prevention medication compliance of ischemic stroke patients and its influencing factors.Methods From Beijing Military Region General Hospital during Nov.30th 2007 and Nov.30th 2011,385 patients with ischemic stroke were collected as the research objects,and the information about sex,age,cultural degree,medical expenses,doctor-patient relationship,onset,frequency of ischemic stroke and drug knowledge level,family income,hypertension,diabetes,dyslipidemia,smoking,drinking,obesity,and physical activity reduction were obtained.Then χ2 tests and Logistic regression were used to analyze the compliance.Results Risk factors such as cultural level,medical expenses,doctor-patient relationship,onset frequency,ischemic stroke and drug knowledge level,family income,smoking,drinking,reduced physical activity showed significantly different medication compliance;compliance quality had positive relation with cultural level,medical expenses,doctor-patient relationship,ischemic stroke and drug knowledge level,and family income;negative relation with onset number,smoking,alcohol consumption,and reduced physical activity（P 0.05）.Conclusion Ischemic stroke patients with first time attack with presence of smoking,drinking and reduced physical activity should be paid more attention for its poor drug compliance,by means of strengthened follow-up and monitoring.