阿司匹林在社区管理高血压和糖尿病患者中的用药现状分析

Aspirin medication status analysis in the community management of patients with hypertension and diabetes mellitus

目的分析阿司匹林在高血压和糖尿病患者社区管理中的用药现状。方法 2013年4月至2016年5月在本地6个社区门诊诊疗信息系统中选取600例高血压和380例糖尿病患者为研究对象,根据《中国心血管疾病预防指南》中的推荐标准判断研究对象是否需要采取阿司匹林治疗。统计阿司匹林用药率、心脑血管疾病发生率,并采取问卷和随访调查的方式研究影响阿司匹林用药率的主要因素。结果本次研究最终纳入研究的样本量为848例患者,患者均有服用阿司匹林的行为,包括高血压480例,糖尿病368例。高血压患者中符合一级预防标准的有285例,二级预防的有195例;糖尿病患者中符合一级预防标准的有214例,二级预防的有154例。高血压及糖尿病患者一级预防和二级预防规律服药率均低于不规律服药率(P<0.05)。不规律服药者心脑血管疾病总发生率明显高于规律服药者(P<0.05)。结论目前在社区管理过程中阿司匹林尚未得到广泛地正确使用,应加强社区的宣传教育,纠正患者的用药错误认知,改善阿司匹林的用药现状。

Objective To analyze the status of aspirin in the community management of hypertension and diabetes mellitus patients. Methods From April 2013 to May 2016, 600 patients with hypertension and 380 patients with diabetes mellitus were selected from 6 communities outpatient clinics in the local community. According to the recommended criteria in the Guidelines for Cardiovascular Disease Prevention in China to decide whether the subject needed to be treated with aspirin. The usage of aspirin, the incidence of cardiovascular and cerebrovascular diseases,and the questionnaire and follow-up survey were used to study the main factors of the usage rate of aspirin. Results The final sample included in this study was 848 patients, all of whom had aspirin taking, including 480 cases with hypertension and 368 cases with diabetes mellitus. Of the hypertensive patients, 285 cases were eligible for the primary prevention and 195 cases were secondary prevention; of the diabetic patients, 214 cases were eligible for the primary prevention criteria and 154 cases were secondary prevention. The regular medication rate in patients with hypertensive and diabetes mellitus in primary prevention and secondary prevention were lower than those of the irregular medication rate（P〈0.05）. The total incidence of cerebrovascular disease in irregular medication was significantly higher than that of the regular medication（P〈0.05）. Conclusion Aspirin has not been widely correctly used in the process of community management, it is necessary to strengthen the publicity and education of the community, to correct the misuse of the medication and improve the current status of aspirin.