目的:了解缺血性脑卒中患者二级预防的用药现状,分析影响患者用药依从性的影响因素,为临床规范化用药及预防提供依据.方法:收集2015年10月—2017年3月漯河市第六人民医院收治的缺血性脑卒中患者190例,回顾性分析患者的用药依从性,并对影响用药依从性的因素进行单因素及多因素Logistic回归分析,评价应用不同药物进行二级预防的效果.结果:年龄、婚姻生活状态、药费、是否自行服药、每日服药次数及每日服药数量与患者用药依从性密切相关;长期应用抗血栓药、抗血小板药和其他中成药患者的用药依从性较高;入院检查指标中总胆固醇及低密度脂蛋白水平越低,患者用药依从性越高;复发缺血性脑卒中患者用药依从性低.多分类Logistic回归分析结果显示,与患者用药依从性有关的影响因素包括婚姻生活状态和药费;相对于未婚、离婚及寡居者,已婚患者的用药依从性高,药费低于500元时患者的用药依从性低.61例用药依从性高的患者中,应用调节血脂药、抗血栓药者的阳性事件发生率显著低于未用上述药物者,差异有统计学意义(P<0.05).结论:缺血性脑卒中患者的二级预防用药依从性普遍较差,需加强对患者及家属相关疾病及用药知识的宣教,提高患者用药依从性,改善疾病结局.%OBJECTIVE: To investigate the secondary prevention of medication compliance in patients with ischemic stroke and to analyze the effect factors of medication compliance , so as to provide a certain basis for standardization of clinical medication and prevention .METHODS: 190 patients with ischemic stroke admitted into Luohe the Sixth People's Hospital from Oct.2015 to Mar.2017 were extracted, retrospective analysis was conducted for patients'medication compliance , and single factor and multi-factor Logistic regression analysis was conducted for effect factors of medication compliance , effects of application of different drugs for secondary prevention was evaluated . RESULTS:Ages, marital status, drug costs, whether to take the medicine on their own , daily dose times and daily dose amount were closely connected with medication compliance .Patients with long-term application of antithrombotic drugs, antiplatelet drugs and other Chinese medicine had higher medication compliance .Patients with lower total cholesterol and LDL at admission examination indicators had higher medication compliance .Patients with recurrent ischemic stroke had lower medication compliance .According to Logistic regression model , the effect factors related to medication compliance were marital status and drug costs .Compared with unmarried , divorced and widowed , married patients had higher medication compliance , patients with drug costs <500 yuan had lower medication compliance .As for the 61 cases with higher medication compliance , the incidence of positive events in patients with blood lipids and antithrombotic drugs was significantly lower than that of patients without these drugs , with statistically significant difference ( P <0.05 ) . CONCLUSIONS: The medication compliance for secondary prevention in patients with ischemic stroke is poorer , it is necessary to strengthen the propaganda and education of knowledge of disease and medication for patients and family members , so as to improve the medication compliance and improve the outcomes .
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