冠状动脉粥样硬化性心脏病患者抗血小板治疗的调查分析

Investigation and analysis of antiplatelet therapy in patients with coronary atherosclerotic heart disease

目的:调查了解某院冠状动脉粥样硬化性心脏病(以下简称"冠心病")患者口服抗血小板药物治疗情况,进一步规范医院抗血小板治疗的应用。方法:回顾性调查2015年8月1日—2016年7月31日于某院心血管内科住院的冠心病患者共832例,统计患者基本情况、既往病史、冠心病类型、口服抗血小板药物应用情况和药物品种数发生调整的原因等。结果:冠心病患者出院时口服抗血小板药物治疗品种数发生调整的情况主要为减少抗血小板药物品种数(占比99.14%),用药品种数减少的主要原因为患者/家属用药依从性差(102例,占比43.22%),其次为患者具有极高出血风险(55例,占比23.30%)和高出血风险(48例,占比20.34%)。结论:患者/家属用药依从性差和对出血风险的过度担心制约着冠心病患者的规范化抗血小板治疗,临床药师应合理利用药物治疗数据来开展更具针对性的药学服务,确保患者安全有效的应用抗血小板药物。

OBJECTIVE To investigate and regulate the application of oral antiplatelet agents in patients with coronary ather- osclerotic heart diseases in a hospital. METItODS The data of 832 inpatients with coronary atherosclerotic heart diseases from August 1, 2015 to July 31, 2016 were collected. Then the basic situation of patients, past history, the subtype of coronary heart disease, the application of oral antiplatelet agents and the reasons for drug treatment adjustment were analyzed statistical- ly. RESULTS There were 99. 14% of discharged patients with coronary atherosclerotic heart disease who reduced the species of antiplatelet drugs in our hospital. The main reasons were poor patient medication compliance （102 cases, 43. 22%）, very high bleeding risk （55 cases, 23. 30%） and high bleeding risk （48 cases, 20. 34%）. CONCLUSION The poor patient medica- tion compliance and overly worry about bleeding risk restrict standardized antiplatelet therapy in patients with coronary heart diseases. In order to ensure the safe and effective use of antiplatelet drugs, clinical pharmacists should utilize rational use of the statistical results to carry out the targeted pharmaceutical care.