慢性肾脏病4期药物治疗依从性与预后的临床研究

The clinical study of chronic kidney disease 4 period drug on treating the compliance and prognosis

目的：探讨研究慢性肾脏病（CKD）4期药物治疗依从性与预后的临床效果。方法2010年10月～2014年10月期间，于我院收治的CKD的病历资料中，随机选取64例CKD 4期患者作为研究对象，采用药物治疗依从性量表进行问卷调查，分析其影响依从性的各项因素，并对其患者的预后情况进行随访观察。结果64例CKD 4期患者中，依从性好的有15例（23.44%），依从性差的有49例（76.56%）。在不同因素对其依从性影响方面：药费付款方式为医保的、药物副作用大为否的、患者主观态度为积极的、家庭和谐关系为和睦的、医患信任程度为信任的、日常居住情况为非独居的患者，其依从性往往较高，差异有统计学意义（P＜0.05）。同时，随访1年，依从性较好的患者预后情况恶化或死亡率均明显低于依从性差的患者（13.33%＜38.78%），差异有统计学意义（P＜0.05）。结论 CKD 4期患者的药物治疗依从性较差，其影响因素较多，必须予以多途径干预，以提高其患者的依从性，进而促进预后，缓解病情。

Objective To explore and research the clinical effect of chronic kidney disease 4 period drug on treating the compliance and prognosis.Methods 64 patients with CKD 4 period of the CKD clinical data from October 2010 to October 2014 in my hospital were randomly selected as the research object, who received questionnaires applied by the compliance scales of drug therapy to analyze the factors affecting compliance, and follow-up observation of the prognosis condition.ResultsAmong 64 patients with CKD 4 period,there were 15 cases with good compliance, and 49 cases with poor compliance,which occupied 23.44% and 76.56% respectively. In the respect of different factors affected their compliance,the cost of payment was medical insurance, drug side effects was small, the patients’ subjective attitude was positive, family harmonious relations were harmonious, the trust degree between doctors and patients was trust, and daily living conditions was non living alone in patients,whose compliance tended to be higher.The difference had statistical significance （P〈0.05）.At the same time,1 years of follow-up, the prognosis deterioration and death rate of the patients with good compliance were significantly lower than those of the patients with poor compliance （13.33%〈38.78%）.The difference was statistically significant （P〈0.05）.Conclusion The chronic kidney disease 4 period drug on treating the compliance was poor, which had more influencing factors and received multi pathway intervention to improve the patients’ compliance, further promote the prognosis and alleviate the problem.