乙肝患者口服核苷类药物依从性调查及干预策略.docVIP

乙肝患者口服核苷类药物依从性调查及干预策略【摘要】　目的：了解慢性乙肝患者口服抗病毒药物依从性，对其进行有效干预，提高治疗效果。方法：对160例应用核苷类药物的慢性乙肝患者依从性现状进行调查，将服药依从性好者93例作为观察组，依从性差者67例作为对照组，比较两组患者年龄、自我评估病情、药物费用、肝病认知程度、担心不良反应、医疗费用支付方式、文化程度等方面的差异。结果：服药依从性良好者年龄、自感病情稳定、费用高、肝病认知程度较好、担心不良反应和初中以上文化程度分别是(46.8±5.4)岁、34.41%、47.31%、95.70%、22.58%、86.02%，服药依从性差者则是(51.4±4.7)岁、91.04%、79.10%、22.39%、70.15%、26.87%。结论：慢性乙肝患者口服核苷类药物依从性受多种因素影响，临床医生应依据患者情况设定个体化诊疗方案。 【关键词】　核苷类似物；　依从性；　影响因素 A Study of Adherence with NAs for Chronic Hepatitis B and Management Strategy/YANG Gen-ling.//Medical Innovation of China，2012，9(28):084-085 【Abstract】　Objective:To study influence factor of nucleoside analogues drug compliance in patients of chronic hepatitis B and management strategy.Method:160 patients of chronic hepatitis B treated with nucleoside analogues were divided into two groups:93 cases of patients of chronic hepatitis B with better drug compliance as observation group，67 cases of patients of chronic hepatitis B with bad drug compliance as control group.Age，self assessment condition，drug costs，liver diseases cognitive，worry about adverse reaction，mode of medical charge payment，degree of education were compared.Result:The medicine compliance of 58.2% patients were higher，the medication compliance of 41.8% patients were poorer.Conclusion:Influence of medicine compliance have many factors，clinical doctor should make decisions about the care of individual patients on the basis of patients condition. 【Key words】　Nucleoside analogues;　Drug compliance;　Influence factor First-authors address:Jining Hospital of Infectious Diseases，Jining 272100，China doi：10.3969/j.issn.1674-4985.2012.28.051 乙型病毒性肝炎是一种常见的传染性疾病，要想彻底消灭乙肝病毒相当困难。但由于乙肝病毒的危害性，2010年版慢性乙型病毒性肝炎诊疗指南明确提出最大限度长期抑制乙肝病毒的复制、减轻患者肝脏炎症和纤维化程度，提高患者生存质量为目标[1]。目前常用的抑制病毒复制的药物主要包括干扰素和核苷类药物，考虑到干扰素副作用较大，目前以核苷类药物为主；但是，随着口服核苷(酸)类似物长期应用，不规范停药的问题越来越明显，导致患者肝病复发或促进乙肝病毒变异，进一步成为社会公共卫生问题，加大乙肝防治的难度。因此，慢性乙肝患者服核苷类药物依从性已经成为目前研究的热点。为了解乙肝患者服药依从性情况，并对其进行有效的干预，笔者所在医院于2008年8月-2011年10月对160例门诊和住院患者服核苷类药物依从性情况进行了调查，并对其影响因素进行了分析，现