急性缺血性卒中患者服药依从性与认知功能及照料者负担的关系研究

Preliminary Study of the Association between Medication Compliance and Cognitive Function with Caregiver Burden in Patients with Acute Ischemic Stroke

目的:总结影响急性缺血性卒中(acute ischemic stroke,AIS)患者服药依从性的相关因素,以及服药依从性与认知功能及照料者负担的关系。方法:收集217例AIS患者的临床信息,并使用蒙特利尔认知评估量表(MoCA)、认知障碍初步评价表(Cog-12)评价患者认知功能,Barthel指数评价患者日常生活能力,照料者负担量表(CBI)评价照料者护理负担。随访至出院后6个月,依据服药依从性结果分为依从性好组和依从性差组。应用单因素分析以及多因素Logistic回归分析,筛选出影响AIS患者服药依从性的因素。结果:完成6个月随访的患者共153例,整体服药依从性为44.44%,单药服药依从性由高到低为降糖药物、降压药物、抗血小板药物、他汀类药物和华法林。多因素Logistic回归分析显示,糖尿病史、NIHSS评分、家庭人均月收入、照料年限、CBI的时间依赖负担、情感负担评分均是影响患者服药依从性的独立相关因素。结论:AIS患者服药依从性整体欠佳,要重视照料者在提高患者服药依从性的作用。

Objective:To study the relevant factors affecting medication compliance in patients with acute ischemic stroke(AIS),and the relationship between medication compliance and cognitive function.Methods:A total of 217 of AIS patients were enrolled,the Montreal cognitive assessment(MoCA)and Cognition-12(Cog-12)were applied for the cognitive assessments,the Barthel index for the assessment of daily living ability,and the Caregiver Burden Inventory(CBI)for the caregivers.The patients were divided into poor medication compliance group and good medication compliance group by the medication compliance at 6 months.Results:The 153 patients who completed 6-month follow-up were analyzed and the rate of medication compliance was 44.44%.The medication compliance was highest for diabetes,followed by antihypertensive,antiplatelet,statins and warfarin medications.Multivariable logistic regression analysis showed that the independent predictors of 6-month medication persistence included a history of diabetes,NIHSS score,the family monthly income,the duration of care,time-dependent burden and emotional burden of CBI.Conclusion:Poor medication compliance is prevalent among AIS patients and much more attention should be paid to the caregivers so as to improve patients’medication compliance.