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目的采用横断面调查方法,评估咸阳地区缺血性卒中患者血压控制情况及降压药物的使用现况。方法本调查采用横断面调查方法,对咸阳市区具有代表性的3家三级医院神经内科门诊就诊且诊断明确的缺血性卒中患者近期的血压控制情况及降压药物的使用情况进行调查。结果咸阳市区三家三级医院在规定的时间段2010-04~2010-07参加调查,总计826例缺血性卒中患者纳入分析,其中缺血性卒中伴高血压血压者612例(74.1%),控制达标率[按收缩压(SBP)<140 mm Hg和舒张压(DBP)<90 mmHg]为36.8%(225/612)。伴高血压者612例中,437例患者使用各种降血压药物,根据临床应用情况分为:1、钙通道阻滞剂(calcium channel blocker,CCB)180(41.2%);2、肾素-血管紧张素转换酶抑制剂(angiotensin converting enzyme inhibitor,ACEI)117(26.8%);3、β-受体阻滞剂112(25.7%);4、复方制剂212(48.6%);5、利尿剂48(11.0%);6、血管紧张素I I受体拮抗剂(angiotensin Ⅱ receptor antagonist,ARB)24(5.6%);7、α-受体阻滞剂5(1.2%)。关于未服用药的情况分为:49.8%(87/175)患者认为血压已控制因而停药,其次32.6%(57/175)的患者回答是医生未建议。结论参照临床指南标准要求,咸阳市缺血性卒中患者血压控制水平达标率明显偏低,因此,建议应该从加强对缺血性卒中患者的健康教育,提高缺血性卒中患者对高血压的知晓率入手,急需加强对缺血性卒中患者血压的控制,进一步提高缺血性卒中患者的治疗率以及治疗控制率。
Objective To evaluate the blood pressure control and the use of antihypertensive drugs in patients with ischemic stroke in Xianyang by cross-sectional survey. Methods The survey was conducted by cross-sectional survey to investigate the recent blood pressure control and the use of antihypertensive drugs in outpatients with neurosurgery outpatient clinics in well-defined ischemic stroke patients in three typical tertiary hospitals in Xianyang city. Results Three hospitals in Xianyang city participated in the survey during the prescribed time period from 2010-04 to 2010-07. A total of 826 patients with ischemic stroke were enrolled in the study. Of them, 612 (76.1%) had ischemic stroke with hypertension, Controlled compliance rate was 36.8% (225/612) for systolic blood pressure (SBP) <140 mm Hg and diastolic blood pressure (DBP) <90 mmHg. Of the 612 patients with hypertension, 437 patients underwent various antihypertensive drugs, which were divided into two groups according to clinical application: 1, calcium channel blocker (CCB) 180 (41.2%); 2, renin- ACE inhibitor 117 (26.8%); 3, β-blocker 112 (25.7%); 4, 212 (48.6%) in combination with a diuretic 48 (11.0%); 6, angiotensin Ⅱ receptor antagonist (ARB) 24 (5.6%); 7, α-blockers 5 (1.2%). In the case of no medication, 49.8% (87/175) considered that blood pressure was controlled and discontinued, followed by 32.6% (57/175) of the patients’ answers were not recommended by the doctor. Conclusion According to the requirements of the clinical guidelines, the compliance rate of blood pressure control in patients with ischemic stroke in Xianyang is significantly lower. Therefore, it is suggested that health education should be strengthened in patients with ischemic stroke to improve the awareness of hypertension in patients with ischemic stroke The rate of start, the urgent need to strengthen the control of blood pressure in patients with ischemic stroke, and further improve the treatment of ischemic stroke patients and treatment control rate.