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目的:通过对仁伯爵综合医院就诊的非瓣膜病性心房颤动(房颤)患者数据的分析,揭示中国澳门非瓣膜病性房颤患者抗栓治疗的现状。方法:纳入2014-01至2014-12期间共472例非瓣膜病性房颤患者,平均年龄为(73.4±10.9)岁,女性197例(41.7%),年龄≥75岁的患者244例(51.7%)。分析患者的一般特征、临床特征及抗栓治疗,并计算CHA2DS2-VASc评分,评分≥2分为卒中高危;计算HAS-BLED评分,评分≥3分为出血高危。结果:472例患者的平均CHA2DS2-VASc评分为(3.4±1.8)分,CHA2DS2-VASc≥2分的患者有389例(82.4%);平均HAS-BLED评分为(1.96±1.03)分,HAS-BLED评分≥3分的患者有132例(28.0%)。接受抗血小板治疗的患者184例(38.9%),华法林101例(21.6%),新型口服抗凝药物156例(33.8%);同时接受抗血小板和抗凝治疗的患者22例(4.6%);未用任何抗栓治疗的患者53例(11.2%)。卒中高风险患者抗凝治疗率高,215例(55.3%)CHA2DS2-VASc评分≥2分的患者接受了抗凝治疗,新型抗凝药物应用比例超过华法林。结论:中国澳门地区非瓣膜病性房颤患者具有较高的卒中风险,超过80%的患者CHA2DS2-VASc评分≥2分,多数患者依据卒中危险评分进行抗凝治疗,55.3%的患者接受了抗凝治疗,且新型口服抗凝药物应用超过华法林。
OBJECTIVE: To reveal the status of antithrombotic therapy in patients with non-valvular atrial fibrillation in Macao, China by analyzing the data of patients with non-valvular atrial fibrillation (AF) treated at El Nido General Hospital. METHODS: A total of 472 patients with non-valvular AF were enrolled between 2014-01 and 2014-12, with a mean age of (73.4 ± 10.9) years and 197 females (41.7%), 244 patients (51.7%) older than 75 years %). The general characteristics, clinical characteristics and antithrombotic therapy were analyzed. The CHA2DS2-VASc score was calculated. The score of ≥2 was classified as high risk of stroke. The HAS-BLED score was calculated. The score of ≥3 was classified as high risk of bleeding. RESULTS: The mean CHA2DS2-VASc score was (3.4 ± 1.8) in 472 patients, 389 (82.4%) in patients with CHA2DS2-VASc ≥ 2; the average HAS-BLED score was (1.96 ± 1.03) 132 patients (28.0%) had BLED score ≥3. 184 (38.9%) were receiving antiplatelet therapy, 101 (21.6%) were warfarin and 156 (33.8%) were new oral anticoagulants. Twenty-two patients (4.6% ); 53 patients (11.2%) did not receive any antithrombotic therapy. Anticoagulation was high in patients at high risk of stroke, and anticoagulant therapy was given in 215 patients (55.3%) with a CHA2DS2-VASc score of 2 or greater, with new anticoagulants taking more than warfarin. CONCLUSIONS: Patients with nonvalvular AF in China and Macau have a higher risk of stroke. Over 80% of patients have a CHA2DS2-VASc score of 2 or greater. Most patients undergo anticoagulation based on stroke risk score and 55.3% receive anti-valvular Condensation therapy, and new oral anticoagulant drugs more than warfarin.