摘要
目的:调查我院住院的卒中患者抗栓药物应用及危险因素控制的现状,为卒中患者做好一、二级预防提供参考。方法:对急性脑梗死和脑出血患者的出院带药(方案)进行用药指导,同时前瞻性调查其入院之前抗栓药物的应用及卒中危险因素控制状况,计算危险因素的累积数目和单个危险因素的百分比。结果:入选患者共200例,入院前使用抗栓药物者占49%,其中以规范的剂量和频次服用阿司匹林和氯吡格雷者占59.2%,坚持服药率为49%;在所调查的危险因素中,高血压(79.5%)、纤维蛋白原升高(70.5%)、糖尿病(34%)名列前3位,血脂异常者占23.5%,生活方式中吸烟(31.5%)位居第一;合并高血压者血压控制达标率为31.4%;合并糖尿病者空腹血糖控制理想(4.4～6.1mmol.L-1)、良好(6.2～7.0mmol.L-1)、差(>7.0mmol.L-1)的比例数分别为8.8%,33.8%,32.4%,余为未监测及未治疗者,非空腹血糖控制理想(4.4～8.0mmol.L-1)、良好(8.1～10.0mmol.L-1)、差(>10.0mmol.L-1)的比例数分别为3%,22.1%,50%,余同上。结论:我院卒中患者抗栓药物的应用及危险因素控制现状不容乐观,主要表现在血压、血糖和血脂的控制达标率较低、用药不规范、监测不及时等方面,临床医生、药师应当依照临床指南要求对卒中患者给予正确、全面的指导,以提高药物治疗的依从性和有效性。
OBJECTIVE To investigate the status of the application of antithrombotic and control of risk factor in primary and secondary prevention of stroke and to provide reference for improving the prevention. METHODS All inpatients in diagno sis of acute cerebral infarction and intracerebral hemorrhage were guided for discharge medication and we prospectively investi- gated the application of antithrombotic and control of risk factor before admission. Cumulative number of risk factors and the percentages of single risk factor were calculated. RESULTS 200 patients were involved. 49% cases used antithrombotic before adimission, among them 59. 2% cases were administrated aspirin and clopidogrel in standard dose and frequency and compliance rate was 50~. Hypertension （79. 5%）, elevated fibrinogen （70. 5%）, diabetes mellitus（34%） were the most prevalent risk factors. Patients with dyslipidemia were 23.5% and cigarette smoking was 31.5%. The patients suffering from hypertension with good control of the blood pressure was 31.4.%. The patients suffering from diabetes mellitus with good control of tasting blood-glucose（4. 4 - 6. 1 mmol.L; ） was 8.8% ,had common control （6. 2 - 7. 0 mmol-L1 ）was 33.8% and bad control（〉7. 0 mmol. L＇） was 32. 4%, others were not monitored or treated. The patients suffering from diabetes mellitus with good control of postprandial blood glucose（4. 4- 8. 0 mmol. L-1）was 3%, in had common control （8. 1 - 10. 0 mmol·L-1 ） was 22.1% and bad control （〉10. 0 mmol. L-1 L）was 50~, others were same. CONCLUSION The status of the application of antithrombotic and control of risk factor in primary and secondary prevention on stroke patients in our hospital was not optimistic, there was a small proportion of good control on blood pressure and blood glucose and blood lipid. And there was an abnormal medical conduct in drug therapy and monitoring. Thus, doctors and pharmacists should pay attention to education on stroke patients according to the clinical guideline to improve compliance and effectiveness of drug therapy.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2010年第23期2009-2013,共5页
Chinese Journal of Hospital Pharmacy
关键词
卒中
一
二级预防
抗栓药物
危险因素
stroke
primary and secondary prevention
antithrombotic
risk factor
