甘肃张掖地区农村冠心病患者二级预防用药调查分析

Analysis of Medication of Secondary Prevention about Rural Coronary Heart Disease Patients in Zhangye District

目的:探讨甘肃张掖地区农村冠心病(CHD)患者二级预防用药现状及影响因素,为提高CHD患者二级预防药物的使用率与服药依从性提供参考依据;方法:选择甘肃张掖市及各县区范围内农村CHD患者327人,在患者就诊时通过访谈填写统一的调查表,分析二级预防药物的使用率、服药依从性以及影响因素,并与289名城镇患者进行比较;结果:农村CHD患者抗血小板药、β-受体阻滞剂、他汀类、ACEI/ARB的服药率分别为81.7%、41.9%、34.3%、37.9%;联合用药中二联、三联、四联用药分别为占50.2%、16.5%、7.0%,均低于本地区城市CHD患者;93.0%患者服药依从性较差,对CHD药物预防认识不足,服药随意性强是影响服药依从性的主要原因.结论:张掖地区农村CHD患者二级预防药物的使用与指南要求有很大差距,应提高基层医师和CHD患者对二级预防药物益处的认识,提高药物的使用率与服药依从性.

OBJECTIVE To understand factors and influence with Medication of Secondary Prevention of the rural patients with coronary heart disease（CHD）in Zhangye of Gansu province, and to provide the scientific basis for prevention and treatment of CHD. METHODS Choosing 327 CHD patients in the rural area of Zhangye,Gansu province, the unified questionnaire is filled in while patients are interviewed in order to analyze the using rate of Discharge Medication of Secondary Prevention following its comparison with the 289 urban patients. RESULTS As for the urban patients, medication rate of Antiplatelet, beta blockers, statins, ACEI/ARB are respectively 81.7%, 41.9%, 34.3% , 37.9%; two,triple,quadruple medication respectively account for 50.2% ,16.5% ,7% in the combination therapy in patients with coronary heart disease,which are lower than that for CHD city patients in Zhang ye city; 93% patients＇ taking medicine compliance is poor,and they lack awareness of drug prevention for coronary heart disease,but taking strong randomness is the main factor influencing the compliance. CONCLUSION There is a big gap between Discharge Medication of Secondary Prevention and guide drug requirements; physicians and patients should raise the awareness and pay attention to the benefits for the Discharge Medication of Secondary Prevention, enhancing the use rate and medication compliance of drug.