头颈部血管支架植入术后患者服用抗血小板聚集药依从性的研究

Medication adherence of patients with Antiplatelet drug treatment after head and neck endovascular stent implantation: An observational study

目的了解接受血管内支架植入术(ESI)的缺血性脑血管病(ICVD)患者术后对抗血小板聚集药物治疗(APT)的依从性及其影响因素。方法收集138例头颈部血管支架术后1年以上的患者,采用改良Morisky量表评估患者对APT的依从性及可能的影响因素,以得分>7.50分定义为服药依从性好,≤7.50分为服药依从性差;用多因素Logistic回归方法分析影响患者服药依从性的因素。结果 138例行头颈部血管支架植入术的患者中术后76例(55.07%)APT依从性良好,62例(44.93%)APT依从性差。服药依从性差主要与初中文化程度、无医疗保险、吸烟、不了解抗血小板聚集药需要的时间等相关。结论行ESI的ICVD患者的APT依从性亟待提高。对文化程度偏低、无医疗保险、吸烟的患者,应加强教育,反复告知需要APT的时间及服药的重要性,以减少缺血性脑血管病的复发。

Objective To determine the influence factors of medication adherence of patients with Ischemic cerebrovascular disease（ ICVD） after endovascular stent implantation（ ESI）. Methods 138 cases of patients with head and neck of ESI were enrolled for more than 1 year. The modified 8-item morisky medication adherence scale（ MMAS-8） was used to evaluate patients＇ adherence to antiplatelet therapy（ APT） and the possible influencing factors. The score of MMAS-8 more than 7. 50 was defined as higher APT adherence,score 7. 50 or less was divided into poor APT compliance. The influencing factors of APT compliance were analyzed by multivariate logistic regression analysis. Results Among 138 patients,76 cases（ 55. 07%） had higher APT adherence,62 cases（ 44. 93%） had poor APT adherence. Poor adherence to APT was mainly associated with junior high school education,without medical insurance,smoke,unaware how long antiplatelet drugs should be made. Conclusion In the ICVD patients after ESI,the APT adherence should be enhanced. To reduce the frequency and severity of ICVD relapses,it was necessary to emphasize the importance of APT in prevent stroke and how long APT should be taken to patients with junior high school education,smoke and without medical insurance.