不同年代缺血性脑卒中住院患者抗血小板药物的应用情况分析

发布时间：2018-05-14 01:41

本文选题：缺血性脑卒中 + 抗血小板药物　；参考：《大连医科大学》2014年硕士论文

【摘要】：目的：了解不同年代辽宁省人民医院缺血性脑卒中住院患者抗血小板药物的使用情况，探讨缺血性脑卒中患者抗血小板药物应用的影响因素。方法：本研究为回顾性病例分析。研究对象为辽宁省人民医院神经内科2002年、2005年、2008年、2011年住院的缺血性脑卒中患者，收集患者相关的临床资料，主要包括：性别、年龄、吸烟情况、既往缺血性脑卒中病史、高血压病史、糖尿病病史、冠心病病史、血脂异常情况。分组：相同年份的缺血性脑卒中病例为同一组别，各年份之间的缺血性脑卒中病例形成相互对照组。结果：共收集资料完整的急性缺血性脑卒中病例648例：2002年为137例、2005年为139例、2008年为180例、2011为192例。4个年份病例的平均年龄、性别构成比、吸烟情况、既往缺血性脑卒中病史、冠心病病史、高血压病史、糖尿病病史、血脂异常病史的比较差异无统计学意义(p㧐0.05)。648例缺血性脑卒中患者住院期间抗血小板药物总体使用率为86.73%（562/648），其中阿司匹林的使用率最高，为95.02%(534/562)；2002年抗血小板药物使用率为81.02%（111/137），2005年使用率为82.01%（114/139），2008年使用率为88.33%(159/180)，2011年使用率为92.71%（178/192），随着年代的推移，4个年份间抗血小板药物使用率总体呈升高趋势，各组别抗血小板药物使用率的比较（81.02%VS82.01%VS88.33%VS92.71%），其差异有统计学意义（2=12.23，P㩳0.05）。影响缺血性脑卒中患者服用抗血小板药物的因素有：年龄、既往缺血性脑卒中病史、高血压病。与缺血性脑卒中服用抗血小板药物独立相关的因素：年龄（60-69岁OR=2.44，95%CI：1.06～5.61；P0.05；VS70-79岁OR=2.14，95%CI：1.02～4.52；P0.05）、既往卒中病史（OR=1.69，95%CI：1.02～2.78；P0.05）、高血压病史（OR=2.02，95%CI：1.26～3.27；P0.05）。结论：1.辽宁省人民医院神经内科早年缺血性脑卒中患者抗血小板药物的使用率仍较高（与其他相关文献报道的比较），且逐年增加。2.数据分析得出很多因素可以影响缺血性脑卒中患者服用抗血小板药物，，其中年龄在50-59岁年龄段患者的服药率高于60-69岁年龄段，60-69岁年龄段患者的服药率高于70-79岁年龄段，既往缺血性脑卒中病史、高血压病、血脂异常患者的服药率高于无此类合并症的缺血性脑卒中患者。3.患者的年龄、既往缺血性脑卒中病史、高血压病与缺血性脑卒中患者服用抗血小板药物独立相关。
[Abstract]:Objective: to investigate the use of antiplatelet drugs in patients with ischemic stroke in Liaoning Provincial people's Hospital in different periods and to explore the influencing factors of antiplatelet drug use in patients with ischemic stroke. Methods: this study was a retrospective case analysis. The subjects of the study were the patients with ischemic stroke hospitalized in 2002, 2005, 2008 and 2011 in Liaoning Provincial people's Hospital. The clinical data of the patients were collected, including gender, age, smoking status, past history of ischemic stroke. History of hypertension, diabetes, coronary heart disease, dyslipidemia. Group: the ischemic stroke cases in the same year were in the same group, and the ischemic stroke cases in each year formed a mutual control group. Results: a total of 648 cases of acute ischemic stroke with complete data were collected: 137 cases in 2002, 139 cases in 2005, 192 cases in 2008 and 2011. The average age, sex composition, smoking status, past history of ischemic stroke were measured in 4 years. There was no significant difference in the history of coronary heart disease, hypertension, diabetes, and dyslipidemia. The overall utilization rate of antiplatelet drugs in patients with ischemic stroke during hospitalization was 86.73 / 562 / 648, among which aspirin was the highest. For 95.02 / 534 / 562; in 2002, the use rate of antiplatelet drugs was 81. 02% 131 / 131; in 2005, the rate was 82. 01% / 139; in 2008, it was 88.33 / 159 / 180; in 2011, it was 92.71 / 178 / 192; and with the passage of time, there was an overall increase in the use of antiplatelet drugs over the four years. Comparison of antiplatelet drug utilization rates in different groups: VS82.011and VS88.33. The difference was statistically significant (P < 0.01). The factors influencing the antiplatelet drugs in patients with ischemic stroke were age, history of ischemic stroke and hypertension. The factors related to the independent use of antiplatelet drugs in patients with ischemic stroke were as follows: age 60-69 years old OR1. 44 and 95 CI: 1.06 + 5.61% P0.05 and VS70-79 years old OR1. 1495 CI: 1.02n 4.52 CI: 0. 01.6995 CIW 1.02n 2.78 P0. 05, and hypertension history OR2.0295CIU 1.263.27P0. 05. Conclusion 1. The utilization rate of antiplatelet drugs in patients with ischemic stroke in the early years of Department of Neurology, people's Hospital of Liaoning Province, was still high (compared with other related literatures, and increased by 0.2% year by year. The data analysis showed that many factors could affect the antiplatelet drug taken by patients with ischemic stroke, and the drug taking rate of patients aged 50-59 years was higher than that of patients aged 60-69 years and 70-79 years old. The rate of medication in patients with previous ischemic stroke history, hypertension and dyslipidemia was higher than that in ischemic stroke patients without such complications. Age, past history of ischemic stroke, hypertension and independent use of antiplatelet drugs were associated with ischemic stroke.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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