Analysis Of The Compliance And Influencing Factors Of Anticoagulant Therapy In Patients With Non Valvular Atrial Fibrillation

Objective:Objective To investigate the compliance status of anticoagulation therapy in patients with non-valvular atrial fibrillation,and analyze the related factors that affect the compliance of anticoagulation therapy,so as to provide guidance for future treatment and nursing.Method:1.The research object is 147 cases of non-valvular atrial fibrillation in lianyungang first people’s hospital digital case retrieval system.2.The status of anticoagulant treatment compliance of patients with non valvular atrial fibrillation was investigated by general data and history of disease questionnaire,self symptom concern questionnaire(CHA2DS2-VASc),HAS-BLED atrial fibrillation risk score,and anticoagulant compliance questionnaire of patients with atrial fibrillation..3.SPSS23.0 statistical software was used to analyze the collected data.The measured data conformed to normal distribution were represented by mean number of standard deviation,and the differences between groups were compared by T test or multi group LSD-t test.Counting data were expressed by frequency(frequency),and chi square X2 test was used to analyze the difference between groups.In addition,the scores of the compliance of the patients with anticoagulant therapy in NVAF were measured as the variables,and the dependent variables were the independent variables,and the multiple linear regression analysis model was used to analyze the risk factors for the compliance of the anticoagulant treatment of NVAF patients.P < 0.05 thought there was statistical significance.Result1.The total score of anticoagulant treatment compliance in 147 NVAF patients was(22.51±5.46),and the score after conversion was(62.53 ±15.17).According to the compliance score of each dimension,the regular monitoring compliance score was(9.73 ± 1.97),and the score was(81.08 ± 16.41)after conversion;the abnormity treatment compliance score(12.78 ± 4.55),and the score after conversion were(53.25 ± 18.96),and the regular monitoring compliance was better than the abnormal disposition.According to the score of each item,the scores of the two items were the highest(3.51 ± 0.76)and the regular out-patient review(3.16 ± 0.92),and the score of the monitoring pulse(1.97 ± 0.96)was lower..2.Of the 147 NVAF patients,there were 72 cases of INR monitoring in the near half of the year,with a mean INR of 1.78 + 0.36,of which 51(70.8%)were NVAF patients with INR<2.0,11 of NVAF in INR>3.0(15.3%),and INR belonging to 10 cases(13.9%)of NVAF patients between 2.0-3.0..3.Among the 147 patients with NVAF,87(59.18%)were concerned with the symptoms of cerebral infarction,74(50.34%)were concerned with the symptoms of myocardial infarction,75(51.02%)concerned with atrial fibrillation,97(65.99%)concerned with the symptoms of renal infarction,and 97 cases(65.99%)concerned with the symptoms of limb infarction..4.The mean CHA2DS2-VASc score of 147 patients with NVAF was(3.26 ± 1.43),122 High risk of stroke(CHA2DS2-VASc≧2 分)was(Occupation ratio 83%),17 Middle stroke risk CHA2DS2-VASc≧2 分)was(Occupation ratio11.6%)and 8 Low risk of stroke(CHA2DS2-VASc=0)was(Occupation ratio5.4%).The risk of bleeding was evaluated with HAS-BLED,the average score was(3.41 ± 1.03),the risk of high risk bleeding(HAS-BLED >3)was 104(Occupation ratio 70.7%),and the risk of low risk bleeding(HAS-BLED<3)was 43(Occupation ratio 29.3%).5.The results showed that "I pay attention to OR=3.058,95%CL:0.029-0.133)and" OR=4.873(95%CL:0.482-1.139)"is the main influence factor(P<0.05)of regular monitoring compliance(P<0.05);" I pay attention to the symptoms of limb infarction "(OR=6.512,95%CL: 0.132-0.247)and "OR=-2.181"(OR=-2.181,95%CL:((-0.102)-((-0.005))are the main influencing factors(P<0.05)for the compliance of abnormal disposal.Conclusion:The situation of anticoagulant intensity monitoring and compliance status of anticoagulant therapy in NVAF patients is not optimistic.It is necessary to make full use of the CHA2DS2-VASc stroke risk stratification assessment tool and the HAS-BLED bleeding risk stratification assessment tool to evaluate the risk of stroke and bleeding risk of NVAF patients,so as to rationally formulate the anticoagulant therapy for NVAF patients.At the same time,the monitoring of anticoagulant intensity,quality of life and compliance with atrial fibrillation of NVAF patients are not optimistic.We must focus on the influence of age,cultural degree,living condition,I pay attention to the symptoms of cerebral infarction,I pay attention to the symptoms of atrial fibrillation,the effect of the symptoms of myocardial infarction on the compliance of NVAF’s patients with atrial fibrillation and so on,so as to give NVAF to the patients with NVAF.Clinical guidance for the application of anticoagulant drugs in patients.