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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 application of antithrombotic drugs and the control of risk factors in stroke patients hospitalized in our hospital, and to provide a reference for primary and secondary prevention of stroke patients. Methods: The patients with acute cerebral infarction and cerebral hemorrhage discharged medication (program) for medication guidance, and prospectively investigated their admission antithrombotic drugs and stroke risk factors control status, calculate the cumulative number of risk factors and individual risk factors Of the percentage. Results: A total of 200 patients were enrolled, with 49% of patients taking antithrombotic drugs before admission. Among them, 59.2% took aspirin and clopidogrel at regular dosage and frequency, and insisted on the rate of 49%. In the survey of risk factors (79.5%), fibrinogen (70.5%), diabetes (34%) ranked the top three, dyslipidemia accounted for 23.5%, lifestyle smoking (31.5%) ranked first; The blood pressure control rate in patients with hypertension was 31.4%. The patients with diabetes mellitus had good fasting blood glucose control (4.4-6.1mmol.L-1), good (6.2-7.0mmol.L-1), poor (> 7.0mmol.L- 1) were 8.8%, 33.8% and 32.4%, respectively. The remaining patients were non-monitored and untreated, with non-fasting glucose control (4.4-8.0 mmol.L-1) and good (8.1-10.0 mmol.L- 1), poor (> 10.0mmol.L-1) the proportion of 3%, respectively, 22.1%, 50%, the same as above. Conclusion: The application of antithrombotic drugs in stroke patients and the control of risk factors in our hospital are not optimistic. The main manifestations are that blood pressure, blood glucose and lipid control rate is low, the medication is not standardized, and the monitoring is not timely, clinicians and pharmacists should follow the Clinical guidelines require that patients with stroke be given proper and comprehensive guidance to improve adherence and effectiveness of medication.