摘要
目的分析220例冠心病(CHD)患者阿司匹林二级预防情况、再入院率及影响因素。方法选取220例CHD患者均给予阿司匹林二级级预防干预,根据患者1年内住院次数分为无再住院组(1年内住院1次)与再住院组(1年内因CHD住院2次及以上),收集患者一般资料、行为特征、CHD特殊治疗经历、相关生理指标、治疗依从性等资料并进行统计学处理。结果 220例患者1年内再入院率为17. 73%(39/220);无再住院组、再住院组患者的性别、CHD家族史、合并慢性疾病、饮酒情况、舒张压、空腹血糖、胆固醇等资料比较,差异无统计学意义(P> 0. 05);与无再住院组相比,再住院组年龄、吸烟率及收缩压、脑钠肽(BNP)、C反应蛋白(CRP)水平显著较高,治疗自费率、合理饮食和规律运动者占比、CHD特殊治疗经历[急诊溶栓、经皮冠状动脉介入术(PCI)、冠状动脉搭桥术]占比显著较低,治疗依从性显著更差,差异均有统计学意义(P <0. 05)。Logistic多因素分析显示,高龄、非自费治疗方式、吸烟、治疗依从性差、高BNP及高CRP水平是CHD患者阿司匹林二级预防干预后1年内再入院的危险因素(P <0. 05),而合理饮食、规律运动、PCI、冠状动脉搭桥术是其保护因子(P <0. 05)。结论 CHD患者接受阿司匹林二级预防干预后,受高龄、非自费治疗方式、吸烟、治疗依从性差及高BNP与高CRP水平等的影响可增高再入院率,而合理饮食、规律运动、PCI、冠状动脉搭桥术可一定程度降低其再入院率,临床应采取积极的针对性措施降低患者再入院风险。
Objective To analyze the secondary prevention of aspirin, readmission rate and influencing factors in 220 patients with coronary heart disease (CHD). Methods A total of 220 patients with CHD admitted to our hospital were enrolled in the study, and all patients were given secondary prevention of aspirin. According to the times of hospitalization within 1 year, the patients were divided into non-readmission group (admission once within 1 year) and readmission group (times of admission ≥ twice within 1 year because of CHD). The general data, behavioral characteristics, special treatment experience of CHD, related physiological indicators, and treatment compliance were collected and statistically analyzed. Results The readmission rate of 220 patients was 17.73% in 1 year. There were no significant between-group differences in gender, family history of CHD, complication with chronic diseases, alcohol drinking, diastolic blood pressure, fasting blood glucose and cholesterol( P >0.05). Compared with the non-readmission group, the age, smoking rate, systolic blood pressure, brain natriuretic peptide(BNP) and C reactive protein (CRP) levels were significantly higher, the self-paying rate of treatment, the proportions of patients having reasonable diet and regular exercise, patients having special treatment experience of CHD[emergency thrombolysis, percutaneous coronary intervention(PCI) or coronary artery bypass graft]were lower and treatment compliance was worse in the readmission group ( P <0.05). Multivariate Logistic analysis showed that age, non self-paying, smoking, poor treatment compliance and high levels of BNP and CRP were the risk factors for readmission within 1 year after secondary prevention with aspirin for CHD( P <0.05), while reasonable diet, regular exercise, PCI and coronary artery bypass graft were the protective factors ( P < 0.05). Conclusion Advanced age, non self-paying, smoking, poor treatment compliance and high levels of BNP and CRP can increase the rate of readmission in patients with CHD after secondary prevention with aspirin, while reasonable diets, regular exercise, PCI and coronary artery bypass grafting can reduce the readmission rate to some extent. Therefore, targeted measures should be taken actively to reduce the risk of readmission in clinical practice.
作者
闫秋芬
王军
刘海林
赵兴山
YAN Qiufen;WANG Jun;LIU Hailin;ZHAO Xingshan(Department of Cardiology, Changping District Hospital, Beijing, 100025;Department of Cardiology, Beijing Jishuitan Hospital, Beijing, 100191)
出处
《实用临床医药杂志》
CAS
2019年第6期50-54,共5页
Journal of Clinical Medicine in Practice
基金
首都临床特色应用研究与成果推广(Z161100000516215)
关键词
冠心病
阿司匹林
二级预防
再入院率
影响因素
coronary heart disease
aspirin
secondary prevention
readmission rate
influencing factors
