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目的心房颤动(AF)发病率逐渐升高,本研究对20年跨度的AF住院患者的临床特征进行分析。方法选择1986~1991年、1995~1996、2000~2001、2006年共21年在天津医科大学第二医院心脏科住院、出院诊断为AF(主要诊断或次要诊断)的患者1005例进行临床特征分析。结果①全部共1005例,年龄范围15~96岁,中位数为67岁,AF患者中≥65岁和≥75岁的比例在21年间均逐渐升高,性别的变化,各组男女性别比无统计学意义(p>0.05);②在AF病因中风湿性心脏病居首位,到2006年降至第5位;冠心病从第2位升至第1位(1995年及以后);心力衰竭由第2位(1986)降至第6位(2001年),2006年又升至第4位;③AF合并脑梗塞者,从1986~1991年的11.4%升高至2006年的20.2%;华法令的使用率从1986~1996年的1.6%升至2006年的6.1%;阿司匹林使用率在1986~1991年仅为1.3%,至2006年已达87.7%。结论本研究的初步结果提示,非心脏瓣膜病AF患者已经成为AF最重要的病因,AF合并脑梗塞者比例升高,高龄AF患者的构成比明显增加。抗凝药物和抗血小板药物的应用还远远不够。
Objective The incidence of atrial fibrillation (AF) gradually increased, the study of 20-year span of hospitalized patients with AF clinical features were analyzed. Methods The clinical data of 1005 patients who were hospitalized in Department of Cardiology, Second Hospital of Tianjin Medical University from 1986 to 1991, from 1995 to 1996, from 2000 to 2001 and from 2006 to 2006 were analyzed retrospectively. The clinical characteristics of 1005 patients who were diagnosed as AF (primary or secondary) analysis. Results ①A total of 1005 cases were aged 15-96 years old with a median of 67 years old. The proportion of ≥65 years old and ≥75 years old patients in AF patients increased gradually in 21 years. The gender differences in male and female sex ratio (P> 0.05); ②The incidence of rheumatic heart disease ranked the first in the cause of AF, dropping to the fifth place in 2006; the number of coronary heart disease rose from the second place to the first place (in 1995 and beyond); Heart failure dropped from No. 2 (1986) to No. 6 (2001) and to No. 4 in 2006. ③ The number of AF patients with cerebral infarction rose from 11.4% in 1986-1991 to 20.2% in 2006 ; The usage of warfarin rose from 1.6% in 1986-1996 to 6.1% in 2006; the utilization rate of aspirin was only 1.3% in 1986-1991 and reached 87.7% in 2006. Conclusions The preliminary results of this study suggest that AF patients with nonvalvular valvular disease have become the most important cause of AF. The proportion of patients with AF complicating cerebral infarction is elevated, and the constituent ratio of elderly patients with AF is significantly increased. The use of anticoagulants and antiplatelet drugs is far from enough.