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相關文獻
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題 名 | Prevalence and Associated Factors of Aspirin Use among Adults with Diabetes in Eastern Taiwan=東臺灣糖尿病患服用阿斯匹靈的盛行率與影響因素 |
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作 者 | 傅振宗; 葉日弌; 李燕鳴; 裴馰; 張慈桂; 蕭正光; | 書刊名 | 慈濟醫學 |
卷 期 | 17:4 民94.08 |
頁 次 | 頁233-237+297 |
分類號 | 415.668 |
關鍵詞 | 盛行率; 阿斯匹靈; 糖尿病; Prevalence; Aspirin use; Diabetes; |
語 文 | 英文(English) |
中文摘要 | 目的:美國糖尿病學會在2000年建議所有30歲以上的糖尿病患,必須每天服用阿斯匹靈來預防血管病變。為了探討臺灣東部門診糖尿病患治療時,服用阿斯匹靈的情況及其相關影響因素。材料與方法:我們自2001年東區健保局門診就醫的糖尿病患中,隨機選取四個月,收集其相關資料:包括阿斯匹靈的使用、病人的年齡、性別、種族、瘸病診斷與就診醫院評鑑等級。我們總共選出合乎條件,30歲以上的糖尿病患共有16,356位,然後將病人分成服用阿斯匹靈與沒有服用阿斯匹靈兩組,利用SPSS統計軟體進行分析。結果:所有病患中,只有12.4%使用阿斯匹靈,在年齡方面,使用阿斯匹靈的比例和年齡有正相關,70歲以上的比例最高,有17.3%的病患使用阿斯匹靈,而49歲以下的病患只有5.7%;在種族方面,非原住民有13.1%使用阿斯匹靈,而原住民卻只有9.6/5;在相關併發症方面,合併腦中風或心臟病的病患使用比例較高,分別為49.6%與49.2%,周邊血管疾病病患使用比例只有27.5%。此外,就醫地點也是影響因素,醫學中心的病患使用阿斯匹靈比例為28.8%,其次是社區醫院的13.8%,基層診所使用機率最低,只有7.4%。多變項迴歸分析顯示病患是否合併腦中風或心臟病、就醫地點與病患年齡為有意義的影響因素,其中是否合併心臟病是最重要的影響因素,合併心臟病的病患的使用機率為沒有心臟病的11.91倍(C.L.=10.50-13.50);合併腦中風病患使用阿斯匹靈機率為沒有者的9.83倍;至於是否合併周邊血管疾病並未有差異。在就醫地點方面,到醫學中心或社區醫院就醫的病患使用機率分別為基層認所的3.88與1.42倍。此外,使用阿斯匹靈的機率和年齡有正相關,年齡愈大,使用機率愈高。結論:本研究顯示大部分醫師對於阿斯匹靈使用於糖尿病的初級預防比例嚴重偏低,但是合併腦中風或心臟病的次級預防認知較高;此外,醫學中心的病患使用率最高,基層診所醫師使用率最低;而年齡愈輕的病患,使用阿斯匹靈比例也較低。末來應該加強醫療人員相關繼續教育,宣道服用阿斯匹靈的好處,才能更有效降低糖尿病的血管併發症。 |
英文摘要 | Objectives: Aspirin has been shown to be an effective and relatively safe regimen to prevent cardiovascular disease. This study investigated associated factors and the prevalence of aspirin use among patients with diabetes in eastern Taiwan. Materials and Methods: Data on all ambulatory patients from eastern Taiwan in 2001 were obtained from the Because of National Health Insurance. Among these, 16,356 patients with diabetes aged over 30 years were randomly selected. Patients were categorized into aspirin users and non-users based on whether they had received an aspirin prescription for diabetes. Results: Of all patients, the prescription rate of aspirin was 12.4%. For those aged 70 years old and over, the rate of aspirin prescription was 17.3%, which was the highest, while the rate was only 5.7% for those aged under 50 years. Only 9.6% of aboriginals had an aspirin prescription compared with 13.1% of non-aboriginals. For patients with stroke or coronary heart disease, the rates of aspirin prescription were 49.6% and 49.2%, respectively. Only 27.5% of patients with peripheral vascular disease had an aspirin prescription. The most significant factor in the multivariate analysis associated with aspirin use was patients with aspirin use was patients with coronary heart disease, followed by patients with stroke. However, peripheral vascular disease was not a significant factor. As to medical facilities, patients visiting primary care clinics were less likely to be prescribed aspirin. In addition, the more elderly patients were, the more likely they were to have an aspirin prescription. Conclusions: Aspirin use in diabetic patients is inadequate in eastern Taiwan, and this was worse for those with peripheral vascular disease, for young diabetics, and in those patients without CVD or those being treated at primary care clinics. Further strategic programs are necessary to enforce aspirin use in these patients. |
本系統中英文摘要資訊取自各篇刊載內容。