实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
2015年
7期
55-57
,共3页
冠心病%二级预防%他汀类药物%影响因素分析
冠心病%二級預防%他汀類藥物%影響因素分析
관심병%이급예방%타정류약물%영향인소분석
Coronary disease%Secondary prevention%Statins%Root cause analysis
目的：分析冠心病（ CHD）二级预防中他汀类药物用药依从性的影响因素及其预防对策。方法选取2012—2014年于江苏省南通大学附属医院分院就诊并采用他汀类药物进行二级预防的CHD患者140例，按他汀类药物用药依从性评价标准将CHD患者分为依从性好组90例及依从性差组50例。分析年龄、性别、受教育程度、婚姻状况、家庭支持、居住地、月收入、二级预防知识、他汀类药物不良反应、医疗费用支付方式、复诊条件等因素对患者用药依从性的影响。结果两组患者年龄、受教育程度、家庭支持、居住地、月收入、二级预防知识、他汀类药物不良反应、医疗费用支付方式、复诊条件比较，差异有统计学意义（ P＜0.05）；两组患者性别及婚姻状况比较，差异无统计学意义（P＞0.05）。多因素Logistic回归分析结果显示，年龄≥70岁〔OR＝4.50，95％CI （1.23，30.14）〕、居住地为农村〔OR＝2.80，95％CI （2.02，17.49）〕、缺乏二级预防知识〔OR＝3.97，95％CI （2.08，28.27）〕、担心他汀类药物不良反应〔OR＝3.32，95％CI （1.90，22.45）〕是CHD患者他汀类药物用药依从性差的独立危险因素（ P＜0.05）。结论年龄≥70岁、居住地为农村、缺乏二级预防知识、担心他汀类药物不良反应是CHD患者他汀类药物用药依从性差的独立危险因素，医务工作者应多关心老年患者，加大对患者CHD二级预防知识的宣教力度，普及他汀类药物不良反应较少的相关知识，以减少患者不按时服药情况以及长期用药的抵触心理，从而更好地实施CHD二级预防。
目的：分析冠心病（ CHD）二級預防中他汀類藥物用藥依從性的影響因素及其預防對策。方法選取2012—2014年于江囌省南通大學附屬醫院分院就診併採用他汀類藥物進行二級預防的CHD患者140例，按他汀類藥物用藥依從性評價標準將CHD患者分為依從性好組90例及依從性差組50例。分析年齡、性彆、受教育程度、婚姻狀況、傢庭支持、居住地、月收入、二級預防知識、他汀類藥物不良反應、醫療費用支付方式、複診條件等因素對患者用藥依從性的影響。結果兩組患者年齡、受教育程度、傢庭支持、居住地、月收入、二級預防知識、他汀類藥物不良反應、醫療費用支付方式、複診條件比較，差異有統計學意義（ P＜0.05）；兩組患者性彆及婚姻狀況比較，差異無統計學意義（P＞0.05）。多因素Logistic迴歸分析結果顯示，年齡≥70歲〔OR＝4.50，95％CI （1.23，30.14）〕、居住地為農村〔OR＝2.80，95％CI （2.02，17.49）〕、缺乏二級預防知識〔OR＝3.97，95％CI （2.08，28.27）〕、擔心他汀類藥物不良反應〔OR＝3.32，95％CI （1.90，22.45）〕是CHD患者他汀類藥物用藥依從性差的獨立危險因素（ P＜0.05）。結論年齡≥70歲、居住地為農村、缺乏二級預防知識、擔心他汀類藥物不良反應是CHD患者他汀類藥物用藥依從性差的獨立危險因素，醫務工作者應多關心老年患者，加大對患者CHD二級預防知識的宣教力度，普及他汀類藥物不良反應較少的相關知識，以減少患者不按時服藥情況以及長期用藥的牴觸心理，從而更好地實施CHD二級預防。
목적：분석관심병（ CHD）이급예방중타정류약물용약의종성적영향인소급기예방대책。방법선취2012—2014년우강소성남통대학부속의원분원취진병채용타정류약물진행이급예방적CHD환자140례，안타정류약물용약의종성평개표준장CHD환자분위의종성호조90례급의종성차조50례。분석년령、성별、수교육정도、혼인상황、가정지지、거주지、월수입、이급예방지식、타정류약물불량반응、의료비용지부방식、복진조건등인소대환자용약의종성적영향。결과량조환자년령、수교육정도、가정지지、거주지、월수입、이급예방지식、타정류약물불량반응、의료비용지부방식、복진조건비교，차이유통계학의의（ P＜0.05）；량조환자성별급혼인상황비교，차이무통계학의의（P＞0.05）。다인소Logistic회귀분석결과현시，년령≥70세〔OR＝4.50，95％CI （1.23，30.14）〕、거주지위농촌〔OR＝2.80，95％CI （2.02，17.49）〕、결핍이급예방지식〔OR＝3.97，95％CI （2.08，28.27）〕、담심타정류약물불량반응〔OR＝3.32，95％CI （1.90，22.45）〕시CHD환자타정류약물용약의종성차적독립위험인소（ P＜0.05）。결론년령≥70세、거주지위농촌、결핍이급예방지식、담심타정류약물불량반응시CHD환자타정류약물용약의종성차적독립위험인소，의무공작자응다관심노년환자，가대대환자CHD이급예방지식적선교력도，보급타정류약물불량반응교소적상관지식，이감소환자불안시복약정황이급장기용약적저촉심리，종이경호지실시CHD이급예방。
Objective To explore the influencing factors of statins medication compliance in the secondary prevention for coronary heart disease and its countermeasures.Methods Between 2012 and 2014 in the Branch of Affiliated Hospital of Nantong University, a total of 140 coronary heart disease patients received statins for secondary prevention were enrolled in this sturdy.According to the statins medication compliance evaluation criterion, the 140 patients were divided into A group ( with good medication compliance, n=90) and B group (with poor medication compliance, n=50).The influence of age, gender, educational level, marital status, family property support, place of residence, monthly income, secondary prevention knowledge, statins adverse reactions, payment method of medical expenses, subsequent visit conditions on statins medication compliance was analyzed.Results There were statistically significant differences of age, educational level, family property support, place of residence, monthly income, secondary prevention knowledge, statins adverse reactions, payment method of medical expenses, subsequent visit conditions between the two groups (P<0.05), while no statistically significant differences of gender or marital status was found between the two groups ( P>0.05) .Multivariate Logistic regression analysis showed that, age equal or over 70 years old 〔OR=4.50, 95%CI (1.23, 30.14)〕, living in countryside 〔OR=2.80, 95%CI (2.02, 17.49)〕, lack of secondary prevention knowledge 〔OR =3.97, 95%CI ( 2.08, 28.27 )〕, worry about statins adverse reactions 〔OR=3.32, 95%CI ( 1.90, 22.45 )〕 were independent risk factors of poor statins medication compliance of coronary heart disease patients (P <0.05).Conclusion Age equal or over 70 years old, living in countryside, lack of secondary prevention knowledge, worry about statins adverse reactions are independent risk factors of poor statins medication compliance of coronary heart disease patients; medical worker should pay more attentions to the aged patients, strengthen the propaganda and education of secondary prevention knowledge for coronary heart disease, popularize the knowledge about mild statins adverse reactions, in order to reduce the incidence of unregularly taking medicine and conflict psychology for long-term taking medicine, to preferably carry out the secondary prevention for coronary heart disease.
