论文部分内容阅读
目的对心房颤动的病因进行分析,并比较房颤合并不同疾病患者栓塞并发症的发生率。方法选择1997年至2005年在北京安贞医院住院并进行冠状动脉造影的房颤患者782例,其中风湿性心脏病273例,冠心病266例,非风湿瓣膜性心脏病69例,高血压63例,心肌病45例,特发性房颤39例,先天性心脏病17例。观察心电图、超声心动图及冠状动脉造影等进行回顾性分析。结果器质性心脏病患者房颤,以风心病和冠心病最为常见,分别为34.9%和34.0%。风心病患者发生房颤的年龄较冠心病患者轻,风心病房颤患者占中年组(40～60岁)的85.9%,其中女性占54.6%,冠心病房颤患者占老年组(>60岁)的70.4%,其中男性占73.9%,两者差异具有统计学意义,(P<0.01)。而以房颤为首发症状就诊的89例患者中,冠心病仅占12.3%,特发性房颤占43.8%,高血压占31.4%,其他占12.5%。脑栓塞的发生率分别为风心病5.1%,冠心病2.2%,风心病合并冠心病11.7%,其他类型心脏病2.9%。左房血栓的检出率分别为风心病13.9%,冠心病3.1%,风心病合并冠心病15.1%,其他类型心脏病3.3%。结论器质性心脏病并发房颤患者不同病因的年龄、性别的构成差异明显。冠心病房颤患者中,多合并有其他心脏病,如瓣膜性心脏病、高血压等。以房颤为首发症状的患者诊断冠心病应该谨慎。风心病患者合并冠心病并不少见,其栓塞的发生率明显升高,抗凝治疗后房颤患者栓塞并发症的发生率显著下降。
Objective To analyze the causes of atrial fibrillation (AF) and compare the incidence of embolic complications in patients with atrial fibrillation and different diseases. Methods A total of 782 AF patients hospitalized at Anzhen Hospital of Beijing from 1997 to 2005 with coronary artery angiography were enrolled, including 273 cases of rheumatic heart disease, 266 cases of coronary heart disease, 69 cases of non-rheumatic valvular heart disease, 63 cases of hypertension Cases, 45 cases of cardiomyopathy, 39 cases of idiopathic atrial fibrillation, 17 cases of congenital heart disease. Observations of electrocardiogram, echocardiography and coronary angiography were retrospectively analyzed. Results Atrial fibrillation was the most common in patients with organic heart disease, with rheumatic heart disease and coronary heart disease as 34.9% and 34.0% respectively. The incidence of atrial fibrillation in patients with rheumatic heart disease is younger than those in patients with coronary heart disease. Anemia in rheumatic heart disease accounts for 85.9% of the middle-aged patients (40-60 years), of whom 54.6% are women and the elderly with coronary heart disease (> 60) 70.4% of them were male, accounting for 73.9% of men, the difference was statistically significant (P <0.01). Of the 89 patients who were treated with atrial fibrillation, only 12.3% had coronary heart disease, 43.8% had essential atrial fibrillation, 31.4% had hypertension, and 12.5% had other symptoms. The incidence of cerebral embolism were 5.1% of rheumatic heart disease, 2.2% of coronary heart disease, 11.7% of rheumatic heart disease and 2.9% of other types of heart disease. The detection rates of left atrial thrombus were 13.9% for rheumatic heart disease, 3.1% for coronary heart disease, 15.1% for rheumatic heart disease and 3.3% for other types of heart disease. Conclusion There are significant differences in the age and sex of different etiologies of patients with organic heart disease and atrial fibrillation. Coronary heart disease patients with atrial fibrillation, more complicated with other heart disease, such as valvular heart disease, hypertension and so on. Atrial fibrillation as the first symptom of patients with coronary heart disease should be cautious. Coronary heart disease patients with rheumatic heart disease is not uncommon, the incidence of embolization was significantly increased after anticoagulant therapy in patients with atrial fibrillation embolic complications decreased significantly.