影响急性脑梗死患者二级预防用药依从性的调查研究

Investigation of influencing patients' compliance of the secondary prevention of cerebral infarction

目的了解大连西部地区急性脑梗死患者住院期间及出院180 d后二级预防药物和行为修正的依从性现状及依从性下降原因。方法调查2014年4月1日~2015年1月31日符合入组标准的急性脑梗死患者对于抗血小板药聚集药物、他汀药物、降压药物、降糖药物、抗凝药物治疗的使用率、戒烟行为修正率并随访180 d。结果入组患者中使用他汀等药物及抗凝药物依从性偏差,分别是50.1%和40.4%;不同药物二级预防依从性下降的原因不同;180 d后随访发现急性脑梗死发生率为6.4%。结论医生应关注患者有明确循证医学依据的二级预防药物及行为修正的依从性,并了解其下降的原因,采取针对措施提高患者药物治疗及行为修正的依从性。

Objective To investigate the compliance and its decreasing reasons of the secondary preven- tive drugs＇ use and the behavior modification in patients with acute infarction in the western area during hospi- talization and the follow-up for 180 days after discharge. Methods From April 1,2014 to November 30,2014, the use frequency of the secondary preventive drugs （including antiplatelet drug,statin, antihypertensive drug, hypoglycemic agent and anticoagulant drug） and the behavior modification rate of quitting smoking in all pa- tients complied with the inclusion criteria of acute cerebral infarction were investigated,and the cases were fol- lowed up for 180 days. Results The compliances of statins and anticoagulant drugs were poor （50. 1% and 40. 4%, respectively）. The decreasing reasons of compliance for the different secondary preventive drugs were different. After the follow-up for 180 days, the incidence of cerebral infarction was found to be 6. 4 %. Conclusion Doctors should pay close attention to patients＂ compliance of the secondary preventive drugs and behavior modifications according to the evidence-based medicine,and the decreasing reasons to improve patients＇ compliance.