[1]张维雄,李蒙,张桂莲.头颈部血管支架植入术后患者服用抗血小板聚集药依从性的研究[J].卒中与神经疾病杂志,2017,24(05):410-415.[doi:10.3969/j.issn.1007-0478.2017.05.007]
　Zhang Weixiong*,Li Meng,Zhang Guilian*..Medication adherence of patients with Antiplatelet drug treatment after head and neck endovascular stent implantation:An observational study[J].Stroke and Nervous Diseases,2017,24(05):410-415.[doi:10.3969/j.issn.1007-0478.2017.05.007]
点击复制

头颈部血管支架植入术后患者服用抗血小板聚集药依从性的研究()
分享到：

《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第24卷
期数:
2017年05期
页码:
410-415
栏目:
论 著
出版日期:
2017-10-26

文章信息/Info

Title:
Medication adherence of patients with Antiplatelet drug treatment after head and neck endovascular stent implantation:An observational study
文章编号:
1007-0478(2017)05-0410-06
作者:
张维雄; 李蒙; 张桂莲
710004 西安交通大学第二附属医院神经内科[张维雄 张桂莲(通信作者)]; 陕西省西安市华山中心医院神经内科(李蒙)
Author(s):
Zhang Weixiong*; Li Meng; Zhang Guilian*.
*Department of neurology,The 2nd Affiliated Hospital,Xi'an Jiaotong University,Xi'an 710004
关键词:
支架植入术 缺血性脑血管病 血小板聚集抑制剂 依从性 影响因素
Keywords:
Endovascular stent implantation Ischemic cerebrovascular disease Antiplatelet drugs Medication adherence Influence factors
分类号:
R543.5
DOI:
10.3969/j.issn.1007-0478.2017.05.007
摘要:
目的 了解接受血管内支架植入术(ESI)的缺血性脑血管病(ICVD)患者术后对抗血小板聚集药物治疗(APT)的依从性及其影响因素。方法 收集138例头颈部血管支架术后1年以上的患者,采用改良Morisky量表评估患者对APT的依从性及可能的影响因素,以得分>7.50分定义为服药依从性好,≤7.50分为服药依从性差; 用多因素Logistic回归方法分析影响患者服药依从性的因素。结果 138例行头颈部血管支架植入术的患者中术后76例(55.07%)APT依从性良好,62例(44.93%)APT依从性差。服药依从性差主要与初中文化程度、无医疗保险、吸烟、不了解抗血小板聚集药需要的时间等相关。结论 行ESI的ICVD患者的APT依从性亟待提高。对文化程度偏低、无医疗保险、吸烟的患者,应加强教育,反复告知需要APT的时间及服药的重要性,以减少缺血性脑血管病的复发。
Abstract:
ObjectiveTo determine the influence factors of medication adherence of patients with Ischemic cerebrovascular disease(ICVD)after endovascular stent implantation(ESI).Methods 138 cases of patients with head and neck of ESI were enrolled for more than 1 year.The modified 8-item morisky medication adherence scale(MMAS-8)was used to evaluate patients' adherence to antiplatelet therapy(APT)and the possible influencing factors.The score of MMAS-8 more than 7.50 was defined as higher APT adherence,score 7.50 or less was divided into poor APT compliance.The influencing factors of APT compliance were analyzed by multivariate logistic regression analysis.Results Among 138 patients,76 cases(55.07%)had higher APT adherence,62 cases(44.93%)had poor APT adherence.Poor adherence to APT was mainly associated with junior high school education,without medical insurance,smoke,unaware how long antiplatelet drugs should be made.Conclusion In the ICVD patients after ESI,the APT adherence should be enhanced.To reduce the frequency and severity of ICVD relapses,it was necessary to emphasize the importance of APT in prevent stroke and how long APT should be taken to patients with junior high school education,smoke and without medical insurance.

参考文献/References:

[1] 中华医学会神经病学分会.中华医学会神经病学分会脑血管病学组,中华医学会神经病学分会神经血管介入协作组.中国缺血性脑血管病血管内介入诊疗指南2015[J].中华神经科杂志,2015,48(10):830-837.
[2] 倪水妹,叶家薇,张诗吟.冠心病患者支架植入术后服药依从性现状的调查及分析[J].护理与康复,2012,11(5):410-412.
[3] Cuisset T,Quilici J,Fugon L,et al.Non-adherence to aspirin in patients undergoing coronary stenting:negative impact of comorbid conditions and implications for clinical management[J].Arch Cardiovasc Dis,2011,104(5):306-312.
[4] Xiang J,Zhang T,Yang QW,et al.Carotid artery atherosclerosis is correlated with cognitive impairment in an elderly urban Chinese non-stroke population[J].J Clin Neurosci,2013,20(11):1571-1575.
[5] Rocque BG,Jackson D,Varghese T,et al.Impaired cognitive function in patients with atherosclerotic carotid stenosis and correlation with ultrasound strain measurements[J].J Neurol Sci,2012,322(1/2):20-24.
[6] Wang Q,Zhou M,Zhou Y,et al.Effects of carotid endarterectomy on cerebral reperfusion and cognitive function in patients with high grade carotid stenosis:a perfusion weighted magnetic resonance imaging study[J].European Journal of Vascular and Endovascular Surgery,2015,50(1):5-12.
[7] Cheng Y,Wang YJ,Yan JC,et al.Effects of carotid artery stenting on cognitive function in patients with mild cognitive impairment and carotid stenosis[J].Exp Ther Med,2013,5(4):1019-1024.
[8] Morisky De GL,Predictive Validity of a Self-reported Measure of Medication Adherence[J].Med care,1986,24(1):67-74.
[9] Morisky D,Ang A,Krousel-Wood M,et al.Predictive validity of a medication adherence measure in an outpatient setting[J].J Clin Hypertens(Greenwich),2008,10(5):348-354.
[10] Brown MT,Bussell JK.Medication adherence:WHO cares?[J].Mayo Clinic Proceedings,2011,86(4):304-314.
[11] Arnet I,Metaxas C,Walter PN,et al.The 8-item Morisky Medication Adherence Scale translated in German and validated against objective and subjective polypharmacy adherence measures in cardiovascular patients[J].J Eval Clin Pract,2015,21(2):271-277.
[12] Korb-Savoldelli V,Gillaizeau F,Pouchot J,et al.Validation of a French version of the 8-item Morisky medication adherence scale in hypertensive adults[J].J Clin Hypertens(Greenwich),2012,14(7):429-434.
[13] Oliveira-Filho OA,Morisky D,Neves SJ,et al.The 8-item Morisky Medication Adherence Scale:validation of a Brazilian-Portuguese version in hypertensive adults[J].Res Social Adm Pharm,2014,10(3):554-561.
[14] Shin DS,Kim CJ.Psychometric evaluation of a Korean version of the 8-item Medication Adherence Scale in rural older adults with hypertension[J].Australian Journal of Rural Health,2013,21(6):336-342.
[15] Yan J,You LM,Yang QH,et al.Translation and validation of a Chinese version of the 8-item Morisky medication adherence scale in myocardial infarction patients[J].J Eval Clin Pract,2014,20(4):311-317.
[16] Ashur ST,Shamsuddin K,Shah SA,et al.Reliability and known-group validity of the Arabic version of the 8-item Morisky Medication Adherence Scale among type 2 diabetes mellitus patients[J].East Mediterr Health J,2015,21(10):722-728.
[17] Fabbrini G,Abbruzzese G,Barone P,et al.REASON study group.Adherence to anti-Parkinson drug therapy in the"REASON"sample of Italian patients with Parkinson's disease:the linguistic validation of the Italian version of the"Morisky Medical Adherence Scale-8 items[J].Neurol Sci,2013,34(11):2015-2022.
[18] Albekairy AM,Alkatheri AM,Jarab A,et al.Adherence and treatment satisfaction in livertransplant recipients[J].Saudi J Gastroenterol,2016,22(2):127-132.
[19] Heng JK,Koh LJ,Toh MP,et al.A study of treatment adherence and quality of Life among adults with chronic urticaria in Singapore[J].Asia Pac Allergy,2015,5(4):197-202.
[20] Tandon S,Chew M,Eklu-Gadegbeku CK,et al.Validation and psychometric properties of the 8-item Morisky Medication Adherence Scale(MMAS-8)in Type 2 diabetes patients in sub-Saharan Africa[J].Diabetes Res Clin Pract,2015,110(2):129-136.
[21] Granger BB,Ekman I,Hernandez AF,et al.Results of the chronic heart failure intervention to improve MEdication adherence study:a randomized intervention in high-risk patients[J].Am Heart J,2015,169(4):539-548.
[22] Jura-Szoltys E,Chudek J.Epistaxis as the reason for premature discontinuation of clopidogrel after percutaneous coronary angioplasty with stent implantation[J].Kardiol Pol,2011,69(8):817-823.
[23] 李怡楠.浅谈波兰的教育体系和大学毕业生就业状况[J].北京党史,2007,26(05):62-64.
[24] Spertus JA,Kettelkamp R,Vance C,et al.Prevalence,predictors,and outcomes of premature discontinuation of thienopyridine therapy after drug-eluting stent placement:results from the PREMIER registry[J].Circulation,2006,113(24):2803-2809.
[25] 居克举,杨梅,郭建一,等.缺血性卒中二级预防服用拜阿司匹林的依从性随访研究[J].中国全科医学,2010,13(2):153-154.
[26] Blich M,Zeidan-Shwiri T,Petcherski S,et al.Incidence,predictors and outcome of drug-eluting stent thrombosis in real-world practice[J].J Invasive Cardiol,2010,22(10):461-464.
[27] Ferreira-Gonzalez I,Marsal JR,Ribera A,et al.Background,incidence,and predictors of antiplatelet therapy discontinuation during the first year after drug-eluting stent implantation[J].Circulation,2010,122(10):1017-1025.
[28] Quadros AS,Welter DI,Camozzatto FO,et al.Identifying patients at risk for premature discontinuation of thienopyridine after coronary stent implantation[J].American Journal of Cardiology,2011,107(5):685-689.

更新日期/Last Update: 2017-10-20