本文選題：缺血性腦卒中 + 抗血小板藥物��； 參考：《大連醫(yī)科大學》2014年碩士論文

【摘要】：目的：了解不同年代遼寧省人民醫(yī)院缺血性腦卒中住院患者抗血小板藥物的使用情況，探討缺血性腦卒中患者抗血小板藥物應用的影響因素。 方法：本研究為回顧性病例分析。研究對象為遼寧省人民醫(yī)院神經(jīng)內科2002年、2005年、2008年、2011年住院的缺血性腦卒中患者，收集患者相關的臨床資料，主要包括：性別、年齡、吸煙情況、既往缺血性腦卒中病史、高血壓病史、糖尿病病史、冠心病病史、血脂異常情況。分組：相同年份的缺血性腦卒中病例為同一組別，各年份之間的缺血性腦卒中病例形成相互對照組。 結果：共收集資料完整的急性缺血性腦卒中病例648例：2002年為137例、2005年為139例、2008年為180例、2011為192例。4個年份病例的平均年齡、性別構成比、吸煙情況、既往缺血性腦卒中病史、冠心病病史、高血壓病史、糖尿病病史、血脂異常病史的比較差異無統(tǒng)計學意義(p㧐0.05)。648例缺血性腦卒中患者住院期間抗血小板藥物總體使用率為86.73%（562/648），其中阿司匹林的使用率最高，為95.02%(534/562)；2002年抗血小板藥物使用率為81.02%（111/137），2005年使用率為82.01%（114/139），2008年使用率為88.33%(159/180)，2011年使用率為92.71%（178/192），隨著年代的推移，4個年份間抗血小板藥物使用率總體呈升高趨勢，各組別抗血小板藥物使用率的比較（81.02%VS82.01%VS88.33%VS92.71%），其差異有統(tǒng)計學意義（2=12.23，P㩳0.05）。影響缺血性腦卒中患者服用抗血小板藥物的因素有：年齡、既往缺血性腦卒中病史、高血壓病。與缺血性腦卒中服用抗血小板藥物獨立相關的因素：年齡（60-69歲OR=2.44，95%CI：1.06～5.61；P0.05；VS70-79歲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）、高血壓病史（OR=2.02，95%CI：1.26～3.27；P0.05）。 結論：1.遼寧省人民醫(yī)院神經(jīng)內科早年缺血性腦卒中患者抗血小板藥物的使用率仍較高（與其他相關文獻報道的比較），且逐年增加。2.數(shù)據(jù)分析得出很多因素可以影響缺血性腦卒中患者服用抗血小板藥物，，其中年齡在50-59歲年齡段患者的服藥率高于60-69歲年齡段，60-69歲年齡段患者的服藥率高于70-79歲年齡段，既往缺血性腦卒中病史、高血壓病、血脂異�；颊叩姆幝矢哂跓o此類合并癥的缺血性腦卒中患者。3.患者的年齡、既往缺血性腦卒中病史、高血壓病與缺血性腦卒中患者服用抗血小板藥物獨立相關。
[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.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R743.3

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