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|本期目录/Table of Contents|

襄阳市急性冠脉综合征患者出院后服药情况和相关因素分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2015年第4期
页码:
448-450
栏目:
临床研究
出版日期:
2015-04-20

文章信息/Info

Title:
Medication of patients discharged from hospital and analysis of related factors of acute coronary artery in Xiangyang City
作者:
周汉云; 李 彬; 朱 锐; 吴校林; 润 琦; 关思虞; 赵玉勤
(襄阳市中心医院、湖北文理学院附属医院心内科，湖北 襄阳 441021)
Author(s):
ZHOU Han-yun;  LI Bin;  ZHU Rui;  WU Xiao-lin;  RUN Qi;  GUAN Si-yu;  ZHAO Yu-qin
(Department of Cardiology, Xiangyang Central Hospital & Affiliated Hospital of Hubei University of Art and Science, Xiangyang 441021, Hubei, China)
关键词:
急性冠脉综合征; 服药; 随访; GRACE评分
Keywords:
acute coronary syndrome;  medication;  follow-up;  GRACE score
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 观察和分析襄阳市急性冠脉综合征患者服药情况和相关因素。方法 收集我院已诊断急性心肌梗死或不稳定型心绞痛患者，使用标准的问卷来研究患者坚持服药以及未坚持服药的原因，采用logistic回归分析出院后6个月与12个月的服药情况。结果 在出院的时候药物治疗比例很高（98%服用阿司匹林，85%服用β-受体拮抗剂，97.8%服用他汀类药物），但是在随后的随访中服药比例是减少的。只有72%的出院患者同时服用4种药物（阿司匹林，倍他乐克，血管紧张素转换酶抑制剂或血管紧张素受体拮抗剂和他汀类药物）。而在出院后1年服药比例减少至52.9%，使用logistic回归分析提示在出院以及随访中，医疗保险、血脂异常、高血压病和介入治疗为重要的服药的相关因素，而医生对很大比例的患者服药情况未予宣教，部分药物费用过高也是影响坚持联合用药的原因。结论 襄樊市已诊断急性冠脉综合征患者出院1年时按规范服药率为52.9%，影响服药依从性的因素是是否患有并发症、宣传不到位和费用高。
Abstract:
AIM To study the medications for patients with acute coronary syndrome in Xiangyang City and provide evidence-based medical therapy for acute coronary syndrome patients. METHODS Patients with suspected acute myocardial infarction or unstable angina pectoris admitted to our hospital were included in the study. Data of medication adherence and reasons for nonadherence were collected using standardized questionnaires and Cox regression was used to examine the medication status and associated factors at 6 and 12 months after hospital discharge. RESULTS The percentage of medication adherence was high (98% for aspirin, 85% for β-blockers and 97.8% for statins) at the time of hospital discharge but the percentage decreased during follow-up. Seventy-two percent of the patients were on the four-drug combination therapy (antiplatelet, β-blockers, angiotensin-converting enzyme inhibitor/angiotensin receptor blockers, and statin) at discharge and the percentage reduced to 52.9% 1 year after discharge. Using adjusted logistic regression analyses, medical insurance, dyslipidemia, hypertension, and administration of treatment at discharge and during follow-up were reported. In a substantial proportion of patients, medication was considered “not indicated” by the treating physician. High drug costs were also partially influencing factors for adherence to the combined drugs. CONCLUSION Standardized medication rate of patients with diagnosis of acute coronary syndrome patients discharged from the hospital 1 year was 52.9%. The influencing factors of compliance to medications are complications, indications and high costs.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2013-09-06.
通讯作者：李彬，主任医师，主要从事冠心病、心力衰竭研究 Email：libin09@126.com
作者简介：周汉云，主治医师，硕士 Email：zhy330330@sina.com
更新日期/Last Update: 2015-04-22