摘要
目的分析急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后抗血小板聚集药物治疗依从性的影响因素。方法选取2013年1月—2014年7月在同济大学附属第十人民医院行PCI的AMI患者189例,2016年8—12月对所有患者进行电话回访,记录患者年龄、性别、婚姻状况、文化程度、医疗保险类型、是否退休、距离PCI时间、高血压和糖尿病发生情况、梗死类型、是否随访及随访地点,并记录所有患者回访前主要不良心血管事件(MACE)发生情况。AMI患者PCI后抗血小板聚集药物治疗依从性的影响因素分析采用多因素Logistic回归分析。结果本组患者中PCI后使用抗血小板聚集药物者180例(占95.2%),其中使用双联抗血小板治疗(DAPT)1年及以上者171例(占90.5%);根据抗血小板聚集药物治疗依从性将使用抗血小板聚集药物者分为治疗依从性良好者81例(A组)和治疗依从性不良者108例(B组)。两组患者性别、文化程度、医疗保险类型、是否退休、有无糖尿病、梗死类型及随访地点比较,差异均无统计学意义(P>0.05);两组患者年龄、婚姻状况、距离PCI时间、有无高血压及是否随访比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,与年龄<60岁相比,≥80岁是AMI患者PCI后抗血小板聚集药物治疗依从性的独立影响因素[OR=3.673,95%CI(1.162,11.606),P<0.05];除此之外,婚姻状况[OR=4.225,95%CI(1.800,9.913)]、距离PCI时间[OR=2.347,95%CI(1.190,4.630)]、高血压[OR=2.888,95%CI(1.348,6.185)]亦是AMI患者PCI后抗血小板聚集药物治疗依从性的独立影响因素(P<0.05)。A组患者电话回访前MACE发生率低于B组(P<0.05)。结论抗血小板聚集药物治疗依从性可影响AMI患者PCI后预后,年龄、婚姻状况、距离PCI时间、高血压是AMI患者PCI后抗血小板聚集药物治疗依从性的独立影响因素。
Objective To analyze the influencing factors of anti-platelet aggregation medicine treatment compliance in postoperative acute myocardial infarction（ AMI） patients treated by PCI. Methods A total of 189 AMI patients undergoing PCI were selected in the 10 th People＇ s Hospital Affiliated to Tongji University from January 2013 to July 2014,age,gender,marital status, educational level, types of medical insurance, whether retired or not, duration after PCI, incidence of hypertension and diabetes,types of infarction,received follow up or not and follow-up locations were collected by telephone follow-up from August to December in 2016,and incidence of MACE was recorded before telephone follow-up. Multivariate Logistic regression analysis was used to analyze the influencing factors of anti-platelet aggregation medicine treatment compliance in postoperative AMI patients treated by PCI. Results Of the 189 patients,180 cases received anti-platelet aggregation medicine（ accounting for 95. 2%）, thereinto 171 cases received dual anti-platelet therapy（ accounting for 90. 5%）.According to the anti-platelet aggregation medicine treatment compliance, the 180 patients cases received anti-platelet aggregation medicine were divided into A group（ with good treatment compliance,n = 81） and B group（ with poor treatment compliance,n = 108）. No statistically significant differences of gender,educational level,types of medical insurance,whether retired or not,incidence of diabetes,types of infarction or follow-up locations was found between the two groups（ P〈0. 05）,while there were statistically significant differences of age,marital status, duration after PCI, incidence of hypertension and received follow up or not between the two groups（ P〈0. 05）. Multivariate Logistic regression analysis results showed that,compared with less than years old, equal or over 80 years old was one of independent influencing factors of anti-platelet aggregation medicine treatment compliance in postoperative AMI patients treated by PCI [OR = 3. 673,95% CI（ 1. 162,11. 606）,P〈0. 05]; meanwhile marital status [OR = 4. 225,95% CI（ 1. 800,9. 913） ],duration after PCI [OR = 2. 347,95% CI（ 1. 190,4. 630） ] and hypertension [OR = 2. 888,95% CI（ 1. 348,6. 185） ] were the independent influencing factors,too（ P〈0. 05）. Incidence of MACE of A group was statistically significantly lower than that of B group（ P〈0. 05）.Conclusion Anti-platelet aggregation medicine treatment compliance can significantly affect the prognosis in postoperative AMI patients treated by PCI,age,marital status,duration after PCI and hypertension were independent influencing factors of anti-platelet aggregation medicine treatment compliance in postoperative AMI patients treated by PCI.
出处
《实用心脑肺血管病杂志》
2017年第10期20-23,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
作者简介
通信作者：李伟明,E-mail：18917683469@189.cn
