湘西地区ACS患者PCI术后他汀类药物依从性及影响因素的研究

A Study on Statin Compliance and Influencing Factors in ACS Patients after PCI in Xiangxi Region

摘要: 目的：了解湘西地区ACS患者PCI术后他汀类药物使用依从性现状，探讨其影响因素。方法：通过对2021年06月01日到2022年12月01日期间因ACS在张家界市人民医院行PCI治疗后好转出院6个月的患者进行随访调查，采用多元Logistic回归分析方法对影响他汀类药物服药依从性的影响因素进行分析。结果：本次研究共纳入508例ACS且行PCI术的患者，其中男性352例，女性156例，50岁至70岁的患者占比较高。根据MMAS-8量表评分，其中依从性好组129例，占25.39%；依从性中等组179例，占35.24%；依从性差组200例，占39.37%。服药依从性中等及以上的患者占60.63%。多元Logistic回归分析结果显示性别(OR = 1.551)、年龄(OR = 3.393)、职工医保(OR = 0.158)、生活环境(OR = 0.320)、婚姻状况(OR = 0.156)、退休(OR = 0.001)、学历(OR = 2.541)、是否与子女同居(OR = 3.947)是ACS行PCI术的患者他汀类药物依从性的影响因素。结论：湘西地区行PCI治疗的ACS患者二级预防用药依从性中等以上比例较多，根据其影响因素分析，需要多加关注女性、高龄、居住在农村、文化水平低以及鳏寡患者，采取针对性个体化措施，定期随访，有利于提高他汀类及其他二级预防药物依从性。

Abstract: Objective: To investigate the status quo of statin use compliance in patients with ACS after PCI in Xiangxi region, and to explore the influencing factors. Methods: A six-month follow-up study was conducted on patients who were discharged from Zhangjiajie People’s Hospital after PCI for ACS between June 1, 2021, and December 1, 2022, multiple Logistic regression analysis was used to an-alyze the influencing factors of statin compliance. Results: A total of 508 patients with ACS who un-derwent PCI were included in this study, including 352 men and 156 women, with a higher propor-tion of patients aged 50 to 70 years. According to the score of MMAS-8, there were 129 cases (25.39%) in good compliance group, 179 cases (35.24%) in moderate compliance group, and 200 cases (39.37%) in poor compliance group. 60.63% of the patients had moderate or above compli-ance. Multiple Logistic regression analysis showed that sex (OR = 1.551), age (OR = 3.393), staff health insurance (OR = 0.158), living environment (OR = 0.320), marital status (OR = 0.156), re-tirement (OR = 0.001), education (OR = 2.541) and cohabitation with children (OR = 3.947) were the influencing factors of statin compliance in patients with ACS undergoing PCI. Conclusion: The compliance rate of ACS patients undergoing PCI for secondary prevention in Xiangxi region is more than moderate, we need to pay more attention to women, elderly people, those living in rural areas, those with low education level and those who are widowed or widowed, and take individualized measures and follow up regularly, it is beneficial to improve the compliance of statins and other secondary prevention drugs.