2019 年第 5 期 第 14 卷

心房颤动患者临床现状分析

Clinical analysis of atrial fibrillation

作者：李彦红周荣吕慧巩书文宋雅玲杨志明刘铮韩丽暄薛国芳

英文作者：

单位：030000太原，山西医科大学第二医院心内科（李彦红、周荣、吕慧、巩书文、宋雅玲、杨志明），急诊科（刘铮），老年病科（韩丽暄），神经内科（薛国芳）

英文单位：

关键词：心房颤动；人口学资料；伴随疾病；危险因素；抗栓治疗

英文关键词：

• 摘要：

• 【摘要】目的    分析医院就诊心房颤动（AF）患者的临床现状。方法    收集2016年1月至2018年1月在山西医科大学第二医院就诊的1 326例心房颤动患者病历资料，包括人口学资料、伴随疾病和心血管危险因素、治疗方案选择以及抗栓治疗情况，进行统计学分析。结果    本组患者平均年龄（68±13）岁，70～79岁者占比最高，为31.4%（416/1 326）。男712例，女614例，性别构成比之间差异无统计学意义（P＞0.05）。伴随疾病和心血管危险因素中，合并高血压536例（40.4%），睡眠呼吸暂停综合征107例（8.1%）。心力衰竭和脑卒中/短暂性脑缺血发作人群中持续性心房颤动占比明显高于阵发性心房颤动，冠状动脉粥样硬化性心脏病（冠心病）人群阵发性心房颤动占比明显高于持续性心房颤动（均P＜0.01）。选择射频消融治疗141例（10.6%），左心耳封堵2例（0.2%），其余均选择药物治疗。未接受抗栓治疗243例（18.3%），接受抗血小板治疗717例（54.1%），华法林治疗280例（21.2%），接受华法林治疗患者中国际标准化比值达标率为47.1%（132/280）。结论    本院就诊心房颤动患者以70～79岁为主，性别之间无明显差异；高血压、心力衰竭、冠心病仍为心房颤动主要伴随疾病或心血管危险因素；合并睡眠呼吸暂停综合征需引起关注；接受射频消融治疗比例较低，大多患者选择药物治疗；未接受抗栓治疗比例较高，抗栓治疗及抗栓强度均低于目前指南建议。

• 【Abstract】Objective    To analyze the clinical status of patients with atrial fibrillation(AF) in hospital. Methods    Clinical data of 1 326 AF patients admitted to Second Hospital of Shanxi Medical University from January 2016 to January 2018 were retrospectively reviewed. Demographic data, concomitant diseases and cardiovascular risk factors, therapeutic and antithrombotic options were analyzed. Results    The mean age of the 1 326 patients was （68±13） years; patients of 70-79 years old took the largest percentage ［31.4%(416/1 326)］. There was no significant difference between the composition ratio of males and females(712 cases vs 614 cases) (P＞0.05). Among the cardiovascular risk factors, 536 patients（40.4%） had hypertension and 107 patients(8.1%) had sleep apnea syndrome. In patients with heart failure and cerebral stoke/transient ischemic attack, chronic atrial fibrillation accounted for a higher percentage than paroxysmal atrial fibrillation（P＜0.01）. In patients with coronary atherosclerotic heart disease(CHD), paroxysmal atrial fibrillation accounted for a higher percentage than chronic atrial fibrillation（P＜0.01）. Most patients were treated with medication, only 141 patients(10.6%) had radiofrequency ablation and 2 patients(0.2%) had left atrial appendage occlusion. Ratios of non-antithrombotic treatment, antiplatelet treatment and warfarin treatment were 18.3%（243）, 54.1%（717） and 21.1%（280）; the standard rate of international normalized ratio after taking warfarin was 47.1%（132/280）. Conclusions    Elderly patients (70-79 years old) take the majority of atrial fibrillation in our hospital and there is no significant difference between gender. Hypertension, heart failure and CHD are the main risk factors associated with atrial fibrillation. Patients with sleep apnea syndrome should be paid attention. Drug treatment is the main therapeutic choice and the rate of radiofrequency ablation is low. Receptance of antithrombotic therapy is low and the effect is unsatisfactory.