目的：了解北京市延庆镇医院65岁以上老年人阿司匹林一级预防应用现状，分析影响治疗依从性的因素。方法采用整群抽样的方法于2014年8月-10月参加65岁以上免费健康体检的老年人，详细录入性别、年龄、家庭月人均收入、高血压、糖尿病、血脂异常、吸烟、早发心血管病家族史、尿蛋白、BMI等，从中筛选出符合2011中国心血管疾病阿司匹林一级预防指南的病例共494例，进行现场及电话调查，向患者宣教阿司匹林一级预防获益，对0个月，3个月，6个月对阿司匹林服药情况进行随访，对服药及未服药原因进行登记，观察阿司匹林知晓及治疗情况，使用多因素Logistic回归分析。结果阿司匹林一级预防心脑血管疾病3组间知晓率、治疗率分别进行比较，差异有统计学意义（P<0.05）。 Logistic回归分析发现阿司匹林一级预防服药依从性好主要与高血压显著相关（P<0.01），糖尿病相关P<0.05。结论阿司匹林在65岁以上老年人一级预防心血管疾病服用率远远不足，主要原因为就诊时医生没有建议使用有关，应加强对社区全科医生规范培训及有针对性的对患者进行宣传教育，提高医生对阿司匹林一级预防的认识，使阿司匹林一级预防在心血管疾病危险人群中广泛应用。%Objective To understand the status of applying aspirin in the primary prevention among the elders over 65 and to analyze the factors affecting the treatment compliance. Methods Firstly, with the cluster sampling approach, the research collects those elders' information who are over 65 and had the free physical examinations during the two months between August and October of the year 2014 about their gender, age, family's monthly income per capita, hypertension, diabetes, dyslipidemia, smoking, family history of premature cardiovascular diseases, urinary protein, BMI, etc. After that, it gets 494 cases that are in accordance with the 2011 China's Guidebook to the Primary Prevention of Cardiovascular Diseases with Aspirin. With interviews and telephone inquiries, the researcher informs these patients of the benefits of the primary prevention with aspirin and conducts follow-up investigations on a basis of 0, 3, 6 month (s) about the facts of the taking of aspirin, the reasons of taking and non-taking of the medicine and the information about their awareness and treatment, followed by a multivariable logistic regression analysis. Results The awareness rate and the treatment rate of the primary prevention of cardiovascular diseases with aspirin,compared separately and respectively, the two rates from the three groups of data (both with a P<0.05) are statistically significant. Logistic regression analysis finds the treatment compliance of the primary prevention with aspirin is chiefly relevant to hypertension(P<0.01) and diabetes(P<0.05). Conclusions The taking rate of aspirin in the primary prevention of cardiovascular diseases among the elders over 65 is too low and the main reason is that doctors haven't given patients such advice when they see a doctor. Therefore, it is necessary to strengthen such standard training of the general practitioners at community hospitals and the informing practice towards patients selectively. With doctors' enhanced awareness of the role of aspirin in the primary prevention, it will promote the extensive application of aspirin in the primary prevention of cardiovascular diseases among high-risk patients.
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