›› 2012, Vol. 7 ›› Issue (08): 611-615.

• 论著 • Previous Articles     Next Articles

Application Situation and Influencing Factors of Antihypertensive Drugs in Ischemic Stroke Patients at Discharge

WANG Lin-Yu, WANG Yi-Long, XU Yu-Ming, et al   

  • Received:2011-10-11 Revised:2011-09-11 Online:2012-08-20 Published:2012-08-20
  • Contact: WANG Yong-Jun

缺血性卒中患者出院降压药物应用现状及其影响因素

王林玉1,王伊龙2,许予明1,王拥军2   

  1. 1 郑州郑州大学第一附属医院神经内科2首都医科大学附属北京天坛医院神经内科
  • 通讯作者: 王拥军

Abstract: Objective To evaluate the antihypertensive drugs prescription at discharge in patients withischemic stroke and hypertension, and to identify influencing factors for prescription in 29 hospitalsin China.Methods The investigation was a multicentre cross-sectional study. We prospectively collecteddemographic information, past history, antihypertensive drug prescription at discharge and hospitalmedical resources information.Results We prospectively reviewed the medical records of all patients who were dischargedfrom the neurology department with the diagnosis of ischemic stroke from Mar. 1 to Mar. 31 in2011. Eight hundred and ninety-three ischemic stroke patients with hypertension were assessed.73.35% of patients were prescribed antihypertensive drugs at discharge. Calcium channel blockerprescription ration was the highest(54.54%) in patients who were prescribed one antihypertensivedrug. Multivariate analysis showed atrial fibrillation(OR 0.39; 95%CI 0.22-0.68; P =0.0009)and heart failure(OR 0.32; 95%CI 0.15-0.65; P =0.0017) were related with antihypertensivedrug prescription, while no stroke unit(OR 1.98; 95%CI 1.42-2.75; P <0.0001) and the number ofhospital beds of neurological department <70(OR 1.57; 95%CI 1.12-2.19; P =0.0080) were relatedwith no antihypertensive drug prescription.Conclusion The antihypertensive drug prescription was inadequate in ischemic stroke patients withhypertension in China. Monitoring and improvement should be promoted.

Key words: antihypertensive drugs; medical treatment; secondary stroke prevention; ischemic stroke

摘要: 目的 本研究旨在评估中国城市29家医院缺血性卒中(ischemic stroke,IS)合并高血压病患者出院时降压药物应用情况及其影响因素。方法 本调查为多中心横断面研究,通过连续收集诊断明确的IS患者人口学信息、既往病史、出院降压药物应用及医院资源信息,进行统计分析。结果 2011年3月1~31日期间,29家Ⅱ级或Ⅲ级医院神经内科出院的IS患者,893例合并高血压病,出院时降压药物应用率73.35%,处方一种降压药比例为41.99%。应用的降压药物中,比例最高的是钙离子拮抗剂(54.54%)。多因素分析后显示心房颤动[比值比(odds ratio,OR)0.39;95%可信区间(confidence interval,CI)0.22~0.68;P =0.0009]、心功能不全病史(OR 0.32;95%CI 0.15~0.65;P =0.0017)与应用降压药物有关,而未成立卒中单元(OR 1.98;95%CI 1.42~2.75;P <0.0001)及神经内科病床<70张(OR 1.57;95%CI 1.12~2.19;P =0.0080)与未应用降压药物有关。结论 中国城市卒中合并高血压患者降压药应用率相对不足,应加以改进提高,并合理规范应用。

关键词: 降压药物; 卒中二级预防; 缺血性卒中