缺血性脑卒中患者抗血小板药物依从性现状调查及其与复发关系

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1、授予单位代码10089学号或申请号20153218中国图书分类号R743.3HebeiMedicalUniversity硕士学位论文专业学位缺血性脑卒中患者抗血小板药物依从性现状调查及其与复发关系研究生：岳赞导师：王惠娟教授专业：神经病学二级学院：河北医科大学第二医院2018年3月目录中文摘要·················································································1英文摘要······················

2、···························································2英文缩写·················································································4研究论文缺血性脑卒中患者抗血小板药物依从性现状调查及其与复发关系前言···········································································

3、·······5材料与方法·········································································5结果··················································································8附图·················································································

4、10附表·················································································11讨论·················································································15结论·················································································

5、20参考文献···········································································20综述缺血性脑卒中抗血小板药物应用现状及依从性影响因素········23致谢·····················································································39个人简历···········································

6、····································40中文摘要缺血性脑卒中患者抗血小板药物依从性现状调查及其与复发关系摘要目的：调查缺血性脑卒中患者抗血小板药物依从性现状及其影响因素，分析药物依从性与卒中复发的关系。方法：选取2016.10～2017.02于我院神经内科住院的急性脑梗死患者739例，记录其一般资料及相关危险因素，随访其出院3个月、6个月、1年时抗血小板药物的服用情况、停药原因及复发情况，比较依从性好组与依从性差组复发率，了解抗血小板药物依从性现状及影响因素，并与201

7、4-2015年本院研究结果比较依从性的变化情况。结果：1.739名患者1年累计复发率为9.47%。出院1年时抗血小板依从性好组与差组的卒中复发率分别为8.06%、16.03%（P<0.05）。2.出院3个月、6个月、1年时，服用抗血小板药物的患者例数与占比分别为677（91.61%），635（85.93%），608（82.28%）。随访1年时患者的依从性显著优于2014-2015年同期筛选患者（P<0.05）。3.高血压为影响抗血小板药物依从性的独立因素（OR=1.787，95%CI=（1.133，2.8

8、17），P<0.05），好转自行停药（20.61%）为依从性差的主要原因。结论：1.抗血小板药物依从性差的脑梗死患者复发率较依从性好者高。2.缺血性脑卒中患者抗血小板用药依从性随出院时间延长呈逐渐下降趋势。合并高血压患者的抗血小板药物依从性更佳。好转自行停药为依从性差的主要原因。关键词：缺血性脑卒中,抗血小板药物,依从性,复发,高血压1英文摘要InvestigationofAntiplateletDrugCompliancei