毛素芳+赵素玉+张慧红+张国辉

[摘要] 目的 研究冠脉介入治疗术后患者用药依从性、自我管理现状及其影响因素。方法 采用Morisky-Green测评表对180例支架植入术后8～12个月内患者进行调查，了解患者冠脉介入术后的用药依从性；运用冠心病自我管理行为量表、心理问题筛查问卷、自我管理知识问卷和一般资料调查表，对该患者进行调查，了解该患者的自我管理现状及其影响因素。结果 患者用药依从性均较出院时有所降低，其中对氯比格雷的依从性最高（100.00%），而对ACEI/ARB依从性最低（84.44%）。该患者的管理行为量表得分为（80.46±12.10）分，总得分率为59.65%。多因素分析显示自我管理知识、年龄、疾病医学管理知识、文化程度、收入水平、情绪管理知识、是否高特质怒人群以及是否焦虑等因素影响患者的自我管理行为。结论 经皮冠状动脉支架植入术后患者用药依从性不理想，患者的自我管理行为处于较低水平，需要临床医生及患者共同关注并努力提高。

[关键词] 经皮冠状动脉支架植入术；用药依从性；自我管理

[中图分类号] R473.5 [文献标识码] B [文章编号] 1673-9701（2014）31-0124-05

Study on medication adherence，self-management status and its influencing factors after percutaneous coronary intervention

MAO Sufang1 ZHAO Suyu1 ZHANG Huihong1 ZHANG Guohui2

1.Department of Internal Medicine-Cardiovascular of Lishui People's Hospital in Zhejiang Province，Lishui 323000，China；2.Department of Cardiology of the First Peoples Hosptial of Zhenjiang City in Jiangsu Province， Zhenjiang 212000， China

[Abstract] Objective To study the patients medication compliance and self-management status and its influencing factors after the coronary artery intervention surgery. Methods The Morisky-Green evaluation form was used to investigate 180 patients in the 8th to 12th month after the stent implantation surgery in order to understand their medication compliance after the coronary artery intervention surgery. The self-management behavior scale， psychological problems screening questionnaire， self-management knowledge questionnaire and general information questionnaire for coronary heart disease were used to investigate the patients in order to understand their self-management status and its influencing factors. Results The patients medication compliance all reduced compared to that at discharge from hospital， of which the compliance to clopidogrel was the highest （100.00%） and the compliance to ACEI/ARB was the lowest （84.44%）. The patients management behavior scale score was （80.46±12.10） points and the total scoring rate was 59.65%. Multivariate analysis showed that self-management knowledge， age， medical management knowledge of diseases， educational level， income level， emotion management level， whether high trait anger population or not and whether anxious or not were influencing factors of the patients self-management behavior. Conclusion After the percutaneous coronary stent implantation surgery， the patients medication compliance is not ideal and their self-management behavior is at a low level， so clinicians and patients need to pay joint attention and endeavor to improve.endprint

[Key words] Percutaneous coronary stent implantation； Medication compliance； Self-management

经皮冠状动脉介入治疗术（percutaneous coronary intervention，PCI）后需规律服用抗血小板药物（阿司匹林联合氯吡格雷）、β-受体阻滞剂、他汀类药物、血管紧张素转换酶抑制剂/血管紧张素受体阻断剂等药物以防止支架内再狭窄的发生以及降低心血管不良事件[1]，且PCI术后患者需改变不良的生活习惯，减少可能发生心血管不良事件的危险因素，故PCI术后患者是否规律服药及能否承担自我管理成为医师所关注的重点。……