中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
9期
806-808
,共3页
心房颤动%华法林%病人依从
心房顫動%華法林%病人依從
심방전동%화법림%병인의종
Arterial fibrillation%Warfarin%Patient compliance
目的 了解门诊心房颤动(房颤)患者抗凝治疗的依从性,提高抗凝治疗质量,预防缺血性脑卒中.方法 从北京市城八区选择8所三级医院和7所二级医院,由内科医生对门诊或病房非瓣膜性房颤患者采取统一问卷调查.对抗凝治疗患者分别于调查结束后1年和2年进行随访,了解患者治疗的依从性和效果.结果 583例非瓣膜性房颤患者中110例服用华法林,华法林总体服用率为18.9%,脑卒中高危房颤患者抗凝治疗率为18.2%(85例).开始治疗后3个月国际标准化测量值(INR)达标率为29.2%(7例),超过1年达标率为44.7%(21例).1年随访时服药治疗依从性为80.0%(84例),放弃抗凝治疗的患者中67.8%(19例)在开始治疗的6个月内停药.患者监测依从性较差,23.8%(20例)患者超过2个月监测1次INR值.结论 门诊房颤患者尤其是脑卒中高危房颤患者抗凝治疗率低,抗凝治疗依从性较高,监测依从性有待提高,加强抗凝治疗患者的随访教育尤其是开始治疗后的早期随访教育有助于提高抗凝治疗的依从性.
目的 瞭解門診心房顫動(房顫)患者抗凝治療的依從性,提高抗凝治療質量,預防缺血性腦卒中.方法 從北京市城八區選擇8所三級醫院和7所二級醫院,由內科醫生對門診或病房非瓣膜性房顫患者採取統一問捲調查.對抗凝治療患者分彆于調查結束後1年和2年進行隨訪,瞭解患者治療的依從性和效果.結果 583例非瓣膜性房顫患者中110例服用華法林,華法林總體服用率為18.9%,腦卒中高危房顫患者抗凝治療率為18.2%(85例).開始治療後3箇月國際標準化測量值(INR)達標率為29.2%(7例),超過1年達標率為44.7%(21例).1年隨訪時服藥治療依從性為80.0%(84例),放棄抗凝治療的患者中67.8%(19例)在開始治療的6箇月內停藥.患者鑑測依從性較差,23.8%(20例)患者超過2箇月鑑測1次INR值.結論 門診房顫患者尤其是腦卒中高危房顫患者抗凝治療率低,抗凝治療依從性較高,鑑測依從性有待提高,加彊抗凝治療患者的隨訪教育尤其是開始治療後的早期隨訪教育有助于提高抗凝治療的依從性.
목적 료해문진심방전동(방전)환자항응치료적의종성,제고항응치료질량,예방결혈성뇌졸중.방법 종북경시성팔구선택8소삼급의원화7소이급의원,유내과의생대문진혹병방비판막성방전환자채취통일문권조사.대항응치료환자분별우조사결속후1년화2년진행수방,료해환자치료적의종성화효과.결과 583례비판막성방전환자중110례복용화법림,화법림총체복용솔위18.9%,뇌졸중고위방전환자항응치료솔위18.2%(85례).개시치료후3개월국제표준화측량치(INR)체표솔위29.2%(7례),초과1년체표솔위44.7%(21례).1년수방시복약치료의종성위80.0%(84례),방기항응치료적환자중67.8%(19례)재개시치료적6개월내정약.환자감측의종성교차,23.8%(20례)환자초과2개월감측1차INR치.결론 문진방전환자우기시뇌졸중고위방전환자항응치료솔저,항응치료의종성교고,감측의종성유대제고,가강항응치료환자적수방교육우기시개시치료후적조기수방교육유조우제고항응치료적의종성.
Objective To assess compliance and instability of anticoagulation level in outpatients on oral anticoagulant therapy. Methods Five hundred and eighty three patients with nonvalvular atrial fibrillation from eight general hospitals and seven community health service centers which allocated in eight districts in Beijing city were questioned by physicians. Subjects who were prescribed warfarin treatment were followed up 2 times between March 2008 and April by telephone. Results One hundred and ten of these S83 patients(18.9%) and 85 of 466 patients(18.2% ) at high stroke risk took warfarin. Twenty nigh point two percent of patients achieved the therapeutic INR value in 3 months, and 44.7% achieved the INR target in 1 year. Eighty four of 105 patients(80% ) continue to take warfarin lyear later. Of those patients giving up treatment, 67. 8% of them stopped treatment within 6 months. Over 20% of patients monitored INR value at most once every 3 months. Conclusions The utility of anticoagulation treatment is low in outpatients with nonvalvular atrial fibrillation especially in patients at high stroke risk. The compliance of monitor is poor. Patient education should be done to increase the compliance of anticoagulation treatment.
