目的: 了解缺血性脑卒中二级预防药物依从性情况,明确影响依从性的因素,为改善缺血性脑卒中二级预防效果提供理论依据。方法: 连续登记收集2012年8月至2015年4月期间收治的缺血性脑卒中及短暂性脑缺血发作(transient ischemic attack,TIA)患者395例,在患者出院后第3个月、6个月、9个月、12个月进行随访,了解患者二级预防药物(抗栓药、降脂药、降压药、降糖药)在不同时间点的服药率。结果: 395例患者中失访3例、死亡8例。在出院后第3个月、6个月、9个月、12个月时抗栓药服药率分别为85.6 %、82.6 %、79.2 %,73.4 %,降脂药服药率分别为67.6 %、59.5 %、52.2 %,49.5 %,降压药服药率分别为94.0 %、92.2 %、92.2 %,90.5 %,降糖药服药率分别为92.3 %、93.2 %、89.8 %,89.7 %,各种药物服药率均呈下降趋势,其中降脂药尤为明显。“感觉用处不大”为各种药物主要停药原因。结论: 加强对脑卒中患者的健康教育,提高患者对二级预防的重视程度是提高二级预防药物依从性的关键。
Objective: To understand the medication compliance of secondary prevention of ischemic stroke and its influencing factors, and to provide evidence for the secondary prevention of ischemic stroke.Methods: 395 cases of patients with ischemic stroke and TIA from November 2013 to April 2015 were collected to investigate the use rate of preventive drugs (antithrombotic medicines, antilipemic medicines, antihypertensive medicines, hypoglycemic agents) on the 3rd, 6th, 9th and 12th month after discharged.Results: Among the 395 patients, 3 cases were lost for follow-up and 8 cases died. On the 3rd, 6th, 9th and 12th month after discharged, the antithrombotic medicines treatment rates were 85.6 %, 82.6%, 79.2 % and 73.4 % respectively; the antilipemic medicines treatment rates were 67.6 %, 59.5%, 52.2 % and 49.5 % respectively; the antihypertensive medicines treatment rates were 94.0%, 92.2 %, 92.2% and 90.5 % respectively; the hypoglycemic agents treatment rates were 92.3 %, 93.2 %, 89.8 % and 89.7 % respectively. There was a downward trend in the drug treatment rates, especially in antilipemic medicines. "Feeling useless" was the main reason for drug withdrawal.Conclusion: The health education should be strengthened for patients with stroke and self-management is the key to improve the secondary prevention of medication compliance of ischemic stroke.
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