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目的了解高龄、糖尿病等因素对老年非风湿瓣膜房颤发生脑栓塞前服用华法林和阿司匹林的影响,以及糖尿病、房颤与华法林和阿司匹林用药情况、年龄、性别的关联性。方法通过对196例老年非风湿瓣膜房颤发生脑栓塞的病史收集、脑栓塞发病前6个月华法林和阿司匹林用药情况调查,分为A组(≥3d/周服用华法林)、B组(≥5d/周服用阿司匹林≥75mg/d)、C组(3～4d/周服用阿司匹林≥75mg/d)、D组(<3d/周服用华法林或阿司匹林≥75mg/d)。A组占2.0%、B组占11.7%、C组占35.7%、D组占50.5%。年龄分为>75岁和≤75岁,采用SPSS10.0统计。结果冠心病占39.3%,高血压性心脏病占34.2%;合并有糖尿病患者占24.0%。B组与年龄有关(P<0.01),B组、C组、D组均与糖尿病有关(P<0.01或P<0.05)。Logistic回归分析,糖尿病与年龄、房颤持续时间、冠心病正相关,与服用阿司匹林负关联(P<0.01或P<0.05)。结论老年非风湿瓣膜房颤患者发生脑栓塞前极少服用华法林,服用足量阿司匹林也不多,其房颤病因以冠心病、高血压性心脏病为主,合并糖尿病占有一定比例;糖尿病与年老、房颤持续时间长、冠心病患者有关,影响阿司匹林的服用;年龄>75岁也不能坚持服用足量阿司匹林。老年非风湿瓣膜房颤合并糖尿病或年龄>75岁,应使用华法林抗凝治疗。
Objective To investigate the effects of aging, diabetes and other factors on the incidence of warfarin and aspirin before cerebral embolism in elderly patients with atrial fibrillation, and the association between diabetes mellitus, atrial fibrillation and warfarin and aspirin medication use, age and gender. Methods 196 cases of senile non-rheumatic valvular atrial fibrillation occurred cerebral embolism history collection, six months before the onset of cerebral embolism warfarin and aspirin medication were divided into group A (≥ 3d / week taking warfarin), B (≥5d / week aspirin ≥75mg / d), C (3-4d / week aspirin ≥75mg / d), D (<3d / week warfarin or aspirin ≥75mg / d). A group accounted for 2.0%, B group accounted for 11.7%, C group accounted for 35.7%, D group accounted for 50.5%. Age is divided into> 75 years old and 75 years old, using SPSS10.0 statistics. Results Coronary heart disease accounted for 39.3%, hypertensive heart disease 34.2%; patients with diabetes accounted for 24.0%. Group B was related to age (P <0.01). Group B, C and D were all associated with diabetes (P <0.01 or P <0.05). Logistic regression analysis showed that diabetes was positively correlated with age, duration of atrial fibrillation and coronary heart disease, and negatively correlated with taking aspirin (P <0.01 or P <0.05). Conclusions Elderly patients with non-rheumatic valvular atrial fibrillation rarely take warfarin prior to embolization and take enough aspirin. The cause of atrial fibrillation is mainly coronary heart disease and hypertensive heart disease, with diabetes accounting for a certain proportion. Diabetes mellitus And elderly, long duration of atrial fibrillation, coronary heart disease patients, affecting aspirin use; age> 75 years old can not insist on taking enough aspirin. Aged non-rheumatic valvular atrial fibrillation with diabetes or age> 75 years, warfarin anticoagulation should be used.