医院老年人阿司匹林一级预防心血管疾病现状调查与分析
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摘要
目的探讨医院老年人应用阿司匹林一级预防心血管疾病的现状及影响治疗依从性的因素。方法选取医院2017年10月至12月参加体检的不低于65岁的心血管疾病高危者560例,记录年龄、性别、糖尿病、高血压、血脂异常等一般资料,对入选人群进行现场及电话调查、宣教阿司匹林的一级预防作用。首次调查后第3,6个月分别进行随访,比较阿司匹林知晓率及治疗率,观察服药及未服药原因分布,采用多因素二元Logistic回归分析影响治疗依从性的因素。结果与首次调查情况比较,随访后老年人对阿司匹林的知晓率和治疗率均明显提高(χ~2=404.900,359.451,P <0.001);老年人服用阿司匹林一级预防的依从性与糖尿病[OR=0.592,95%CI(0.431～0.824)]、高血压[OR=0.347,95%CI(0.269～0.901)]有关,差异均有统计学意义(P <0.05)。结论对65岁及以上老年人心血管疾病的一级预防,阿司匹林的应用率偏低,应增强医师对阿司匹林一级预防的认识和重视,并开展有针对性的健康教育,提高应用率和治疗依从性。
Objective To investigate the current situation of primary prevention of cardiovascular diseases with aspirin in elderly people in the hospitals and the factors influencing treatment compliance.Methods Totally 560 patients not less than 65 years old with high-risk cardiovascular disease who took part in the physical examination from October to December 2017 were selected,the general data of age,sex,diabetes,hypertension,dyslipidemia and other information was recorded.Field and telephone surveys were conducted among the selected people,and the primary preventive effect of aspirin was educated.Follow-up was conducted at 3 and 6 months after the first survey,the awareness rate and treatment rate of aspirin were compared,the cause of taking and not taking drugs was observed.Multivariate binary logistic regression was used to analyze the factors affecting treatment compliance.Results Compared with the first survey,the awareness rate and treatment rate of aspirin in the elderly were significantly increased after follow-up(χ~2 = 404.900,359.451,P < 0.001).The compliance of the elderly with primary prevention of aspirin was related to diabetes mellitus [ OR = 0.592,95% CI(0.431-0.824) ],hypertension [ OR = 0.347,95% CI(0.269-0.901) ],and the difference was statistically significant(P < 0.05).Conclusion For the primary prevention of cardiovascular diseases in the elderly aged 65 years and older,the application rate of aspirin is low.It is necessary to enhance doctors' awareness and attention to primary prevention of aspirin,and carry out targeted health education to improve the application rate and treatment compliance.
Objective To investigate the current situation of primary prevention of cardiovascular diseases with aspirin in elderly people in the hospitals and the factors influencing treatment compliance.Methods Totally 560 patients not less than 65 years old with high-risk cardiovascular disease who took part in the physical examination from October to December 2017 were selected,the general data of age,sex,diabetes,hypertension,dyslipidemia and other information was recorded.Field and telephone surveys were conducted among the selected people,and the primary preventive effect of aspirin was educated.Follow-up was conducted at 3 and 6 months after the first survey,the awareness rate and treatment rate of aspirin were compared,the cause of taking and not taking drugs was observed.Multivariate binary logistic regression was used to analyze the factors affecting treatment compliance.Results Compared with the first survey,the awareness rate and treatment rate of aspirin in the elderly were significantly increased after follow-up(χ~2 = 404.900,359.451,P < 0.001).The compliance of the elderly with primary prevention of aspirin was related to diabetes mellitus [ OR = 0.592,95% CI(0.431-0.824) ],hypertension [ OR = 0.347,95% CI(0.269-0.901) ],and the difference was statistically significant(P < 0.05).Conclusion For the primary prevention of cardiovascular diseases in the elderly aged 65 years and older,the application rate of aspirin is low.It is necessary to enhance doctors' awareness and attention to primary prevention of aspirin,and carry out targeted health education to improve the application rate and treatment compliance.
引文
[1]刘颖奇.慢性病综合防控效果评价及对策[D].南京:江苏大学,2017.
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[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心血管病预防指南[J].人人健康,2016,39(14):263-279.
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[7]李小鹰.从国内外指南更新看阿司匹林在心血管疾病一级预防中的作用[J].中华老年心脑血管病杂志,2018,20(1):92-95.
[8]孙艺红,胡大一.我国阿司匹林用于心血管疾病一级预防的挑战和困惑[J].中华内科杂志,2016,55(4):257-259.
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[10]李静,蒋林轩,赵敏.我院516例急性心肌梗死患者二级预防药物应用调查与分析[J].中国药房,2016,27(14):1902-1904.
[11]林鸿波,沈鹏,李小勇,等.阿司匹林在社区管理高血压和糖尿病患者中的用药现状分析[J].中国慢性病预防与控制,2016,24(12):927-929.
[12]高思新.心血管病一级预防应用小剂量阿司匹林的效果及安全性的评价[J].中西医结合心血管病电子杂志,2016,4(35):68-69.
[13]朱建华.《2016年欧洲心血管疾病预防的临床实践指南》解读[J].中国介入心脏病学杂志,2016,24(11):619-622.
[14]李葳,邓雅丽,卓琳,等.阿司匹林对于心血管疾病一级预防的效果及安全性的系统综述及Meta分析[J].中华老年多器官疾病杂志,2016,15(12):896-901.
[2]朱志军.心血管疾病阿司匹林依从性影响因素及干预对策[J].吉林医学,2015,36(17):3848-3849.
[3]廖玉华,杨天伦,高传玉,等.阿司匹林用于心血管疾病一级预防的专家建议[J].临床心血管病杂志,2015,31(9):919-921.
[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心血管病预防指南[J].人人健康,2016,39(14):263-279.
[5]孔翠荣.药物治疗结合综合护理用于老年心血管疾病患者临床评价[J].中国药业,2017,26(14):66-68.
[6]张渊,夏慧玲,王天浩,等.阿司匹林预防心血管疾病的研究进展[J].中国临床医学,2014,21(5):606-608.
[7]李小鹰.从国内外指南更新看阿司匹林在心血管疾病一级预防中的作用[J].中华老年心脑血管病杂志,2018,20(1):92-95.
[8]孙艺红,胡大一.我国阿司匹林用于心血管疾病一级预防的挑战和困惑[J].中华内科杂志,2016,55(4):257-259.
[9]李小鹰.从国内外指南更新看阿司匹林在心血管疾病一级预防中的作用[J].中华老年心脑血管病杂志,2018,20(1):92-95.
[10]李静,蒋林轩,赵敏.我院516例急性心肌梗死患者二级预防药物应用调查与分析[J].中国药房,2016,27(14):1902-1904.
[11]林鸿波,沈鹏,李小勇,等.阿司匹林在社区管理高血压和糖尿病患者中的用药现状分析[J].中国慢性病预防与控制,2016,24(12):927-929.
[12]高思新.心血管病一级预防应用小剂量阿司匹林的效果及安全性的评价[J].中西医结合心血管病电子杂志,2016,4(35):68-69.
[13]朱建华.《2016年欧洲心血管疾病预防的临床实践指南》解读[J].中国介入心脏病学杂志,2016,24(11):619-622.
[14]李葳,邓雅丽,卓琳,等.阿司匹林对于心血管疾病一级预防的效果及安全性的系统综述及Meta分析[J].中华老年多器官疾病杂志,2016,15(12):896-901.