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目的了解阿司匹林在深圳市社区高血压患者健康管理中的应用现状及影响因素,促进阿司匹林在社区高血压患者健康管理中的应用。方法采用面对面问卷调查的方式对所有符合筛选条件的高血压患者的阿司匹林使用情况进行调查,根据服用阿司匹林情况将高血压患者分为3组:规律服药组、不规律服药组、未服用组。然后分析患者不规律服药或未服药的原因。结果接受调查的1325人中,仅312人(23.55%)规律服用阿司匹林,526人(39.70%)从未服用阿司匹林。规律服药组、不规律服药组、未服用组并发其他心脑血管疾病(如血栓栓塞、心肌梗死、心绞痛、冠心病等)的发生率分别为8.01%、14.78%、15.40%,3组比较,差异有统计学意义(χ2=10.40,P<0.05)。3组出血并发症(1年内发生过消化道出血、牙龈出血、皮肤黏膜瘀点瘀斑性出血)发生率比较,差异无统计学意义(χ2=0.49,P>0.05)。患者未服用或不规律服用阿司匹林的主要原因是全科医生指导不到位(57.85%),其次是患者担心出现出血等不良反应(42.25%)及不清楚阿司匹林的适应症(40.57%)。结论阿司匹林在社区高血压患者健康管理中没有得到广泛和正确的使用;社区全科医生对高血压患者使用阿司匹林指导不到位;高血压患者对阿司匹林不良作用的认识存在误区。应加强对社区全科医生及患者的教育和宣传,推动阿司匹林在社区高血压患者健康管理中的广泛应用。
Objective To understand the current status and influencing factors of aspirin in the management of hypertension in community-based community in Shenzhen and to promote the application of aspirin in the management of community-based hypertension. Methods A face-to-face questionnaire was used to investigate the aspirin use in all hypertensive patients who met the screening criteria. Hypertensive patients were divided into three groups according to aspirin treatment: regular medication group, irregular medication group and no medication group. Then analyze the reasons for patients taking or not taking medication irregularly. Results Of the 1325 people surveyed, only 312 (23.55%) regularly took aspirin and 526 (39.70%) never took aspirin. The incidence of other cardiovascular and cerebrovascular diseases such as thromboembolism, myocardial infarction, angina pectoris and coronary heart disease were 8.01%, 14.78% and 15.40% respectively in the regular medication group, the irregular medication group and the non-medication group. Compared with the three groups, The difference was statistically significant (χ2 = 10.40, P <0.05). There was no significant difference in the incidence of bleeding complications in three groups (bleeding in the course of one year, bleeding of gums and ecchymosis of mucocutaneous mucosa in skin) (χ2 = 0.49, P> 0.05). The main reasons that patients taking aspirin unnoticely or irregularly were general practitioners ’lack of guidance (57.85%), followed by patients’ fear of bleeding (42.25%) and indications of aspirin (40.57%). CONCLUSIONS: Aspirin is not widely and correctly used in the management of community-based hypertensive patients. Community GPs are not well placed to use aspirin in hypertensive patients. Misconceptions exist in the understanding of the adverse effects of aspirin in hypertensive patients. Education and publicity for community GPs and patients should be strengthened to promote the widespread use of aspirin in the health management of community-based hypertensive patients.