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临床药师主导的药学强化干预对高血压患者缺血性脑卒中风险的影响
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| 篇名： | 临床药师主导的药学强化干预对高血压患者缺血性脑卒中风险的影响 |
| TITLE： | Effects of intensive pharmaceutical intervention led by clinical pharmacists on the risk of ischemic stroke in hypertensive patients |
| 摘要： | 目的 探讨临床药师主导的药学强化干预对中高危缺血性脑卒中风险的高血压患者的影响。方法选取2019年10月－2020年4月在郑州人民医院就诊且经改良弗明汉卒中量表评估的缺血性脑卒中中高危高血压门诊患者，随机分为对照组和干预组，每组200例。对照组患者接受常规治疗，不接受药学干预；干预组患者在常规治疗的基础上，接受由临床药师提供的为期12个月的药学强化干预（依从性分级管理+定期随访，包括用药教育及指导，血糖、血压、血脂管理和健康生活指导）。比较两组患者入组时和入组12个月后的血糖指标、血脂指标、血压达标率、服药依从性、未来10年卒中发病风险和脑卒中发病率。结果入组12个月后，干预组患者的低密度脂蛋白胆固醇（LDL-C）水平显著低于同组入组时，且其空腹血糖、糖化血红蛋白、总胆固醇、LDL-C水平均显著低于同期对照组（P＜0.05或P＜0.01）；干预组患者的血压达标率、服药依从性均显著高于或优于对照组（P＜0.01）；对照组和干预组分别有12、15例患者转为低危，且干预组高危患者的比例较对照组显著降低（P＜0.01），中危患者的比例较对照组显著升高（P＜0.05）；干预组的脑卒中发病率显著低于对照组（1.0%vs.4.5%，P＜0.05）。结论由临床药师主导的药学强化干预可降低高血压门诊患者的血糖和血脂水平，提高其血压达标率和服药依从性，并有助于降低脑卒中发病风险。 |
| ABSTRACT： | OBJECTIVE To explore the effects of intensive pharmaceutical intervention led by clinical pharmacists on hypertension patients with medium and high risk of ischemic stroke. METHODS The hypertension outpatients with medium and high risk of ischemic stroke， who were assessed by the modified Framingham stroke scale in Zhengzhou People’s Hospital from Oct. 2019 to Apr. 2020， were randomly divided into control group and intervention group， with 200 cases in each group. Patients in the control group received conventional treatment without pharmaceutical intervention； on the basis of conventional treatment， patients in the intervention group received 12-month intensive pharmaceutical intervention （grading management of compliance+ regular follow-up， involving medication education and guidance， blood glucose， blood pressure， blood lipid management and healthy life guidance） provided by clinical pharmacists. The blood glucose indexes， blood lipid indexes， blood pressure compliance rate， medication compliance， 10-year stroke risk and stroke incidence were compared between two groups at baseline and 12 months after enrollment. RESULTS After 12 months of enrollment， the level of low-density lipoprotein cholesterol （LDL-C） in intervention group was significantly lower than that in the same group at baseline， and the levels of fasting blood glucose， glycosylated hemoglobin， total cholesterol and LDL-C in intervention group were significantly lower than those in control group at the same time points （P＜0.05 or P＜0.01）. The compliance rate of blood pressure and medication compliance in intervention group were significantly higher or better than those in control group （P＜0.01）. There were 12 and 15 patients in control group and intervention group turned into low-risk ones respectively， and the proportion of high-risk patients in intervention group was significantly lower than that in control group（P＜0.01）， while the proportion of medium-risk patients was significantly higher than that in control group（P＜0.05）； the incidence of stroke in intervention group was significantly lower than that in control group （1.0% vs. 4.5%， P＜0.05）. CONCLUSIONS The pharmaceutical intensive intervention led by clinical pharmacists can reduce blood glucose and blood lipid levels of hypertensive outpatients， improve their blood pressure compliance rate and medication compliance， and help reduce the risk of stroke. |
| 期刊： | 2023年第34卷第02期 |
| 作者： | 刘秀梅；华之卉；魏炳飞；刘相端；葛春丽；陈楠 |
| AUTHORS： | LIU Xiumei，HUA Zhihui，WEI Bingfei，LIU Xiangduan，GE Chunli，CHEN Nan |
| 关键字： | 临床药师；药学强化干预；高血压；脑卒中风险；门诊患者 |
| KEYWORDS： | clinical pharmacists； intensive pharmaceutical intervention； hypertension； risk of stroke； outpatient patients |
| 阅读数： | 249 次 |
| 本月下载数： | 14 次 |
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