比较城乡区域急性冠脉综合征患者经皮冠状动脉介入治疗（PCI）术后患者的依从性差异，分析影响城乡区域患者依从性差异原因。

本研究采用问卷调查法和半结构访谈法。选择2019年1月1日至5月31日在扬州大学附属医院心血管内科住院的急性冠脉综合征并首次行PCI术的患者进行调查。共发放问卷230份，回收有效问卷217份，对于问卷中不能用评分方法进行的内容，采用半结构访谈法进行补充。通过χ²检验、非参数秩和检验等分析不同数据之间的差异性，使用Logistic回归分析法分析相关危险因素。

城镇患者PCI术后依从性评分高于农村患者［（2.57±0.73）分 vs （2.38±0.80）分，P=0.031）］。通过进一步分析依从性影响因素认为，认知程度对患者依从性有影响（OR=3.593，P=0.012）。通过对比城镇患者与农村患者认知程度发现，城镇居民认知程度高于农村居民［（2.83±0.87）分vs（2.55±0.92）分，P=0.039］水平。对比不同认知程度水平患者的性别、年龄、文化程度水平，发现文化程度存在差异（χ²=9.979，P=0.002）。进一步研究文化程度与认知程度相关性发现，文化程度与认知水平存在相关性（OR=3.431，P=0.002）。在对比城镇居民与农村居民规律复诊、规律服药、自行锻炼情况发现，城镇患者门诊复诊情况优于农村患者（81.1% vs 58.8%，P＜0.001），两组患者在规律服药及规律自行锻炼方面无明显差异性（规律服药：χ²=0.737，P=0.391；规律自行锻炼：χ²=0.391，P=0.246）。对比不同影响门诊复诊原因发现，城镇区域患者主要为缺少时间（48.0%），农村区域患者主要表示居住地区较远，复诊不变（45.7%）。

（1）在急性冠脉综合征PCI术后患者中，城镇区域患者的依从性高于农村区域患者；（2）PCI术后患者依从性受对疾病的认知程度影响，患者的认知程度越高依从性越高；（3）患者文化程度影响患者认知程度，患者文化程度越高，对疾病的认知程度越高，患者文化程度间接影响患者依从性；（4）农村患者规律门诊复诊情况较低，受患者文化程度、认知程度影响，同时部分患者由经济原因、居住地区较远、门诊复诊不便等因素影响。

To analyze the differences of compliance of patients with acute coronary syndrome after percutaneous coronary intervention (PCI) in urban and rural areas, and to analyze the reasons for such differences.

A questionnaire survey and semi-structured interview were used in this study. From January 1, 2019 to May 31, 2019, patients with acute coronary syndrome who were hospitalized at the cardiovascular department of Affiliated Hospital of Yangzhou University were selected for investigation. A total of 230 questionnaires were sent out and 217 valid questionnaires were returned. For the content that cannot be scored in the questionnaire, a semi-structured interview method was used. The chi-square test and nonparametric rank sum test were used to compare differences in data between groups, and logistic regression analysis was used to identify the risk factors for compliance.

The compliance score of urban patients after PCI was higher than that of rural patients (2.57±0.73 vs 2.38±0.80, P=0.031). The knowledge on the disease had a significant impact on compliance (OR=3.593, P=0.012); the knowledge of urban residents was significantly more than that of rural residents (2.83±0.87 vs 2.55±0.92, P=0.039). By comparing the differences in gender, age, and education level of patients with different knowledge levels, we found that there was a significant difference in education level (χ²=9.979, P=0.002). Further correlation analysis showed that there was a significant correlation between education level and knowledge (OR=3.431, P=0.002). With regard to regular follow-up, medication, and self-exercise, it was found that the rate of outpatient follow-up among urban patients was significantly better than that of rural patients (81.1% vs 58.8%, P＜0.01), but there was no significant difference in regular medication or regular self-exercise between the two groups (regular medication: χ²=0.737, P=0.391; regular self-exercise: χ²=0.391, P=0.246). By comparing the factors influencing outpatient follow-up, it was found that lack of time (48.0%) was the main reason for patients in urban areas, while inconvenience due to long distance between residential area and clinic was the main reason for rural patients (45.7%).

In patients with acute coronary syndrome after PCI, the compliance of patients in urban areas is higher than that in rural areas. The compliance of patients after PCI is affected by the knowledge on the disease; the more the knowledge of patients, the higher the compliance. The patient's educational level affects the patient's knowledge level; the higher the patient's educational level, the higher the patient's knowledge level. The patient's educational level indirectly affects the patient's compliance. The regular outpatient follow-up situation of rural patients is worse, which is affected by the patients' education level and knowledge level, and some patients are affected by economic reasons, inconvenient outpatient follow-up, and other factors.