心房颤动住院患者的临床特点及抗凝治疗

Retrospective Study on the Clinical Characteristics and Anticoagulation Therapy of Inpatients with Atrial Fibrillation

【目的】了解现阶段心房颤动(房颤)患者的流行病学变化、临床特征及抗凝治疗情况。【方法】对本院出院诊断为房颤有心脏超声资料的921例患者进行分析。【结果】①住院房颤患者中瓣膜性房颤占房颤病人总数的38.8%;非瓣膜性房颤占61.2%,病因以高血压病、冠心病、孤立性房颤、扩张型心肌病为主。②大于70岁房颤占30.3%,年龄越大房颤发生率越高。③左心房超声记录中左房增大(>40mm)占71.9%;约21.4%有左室射血分数降低;阵发性房颤369例(40.1%),持续性房颤552例(59.9%),持续性房颤患者左心房明显大于阵发性房颤患者(P<0.01)。④应用华发林抗凝治疗76例,仅占8.3%。【结论】非瓣膜性房颤已成为现阶段房颤的主要病因,年龄和高血压是房颤最常见的相关因素。应积极应用华发林抗凝治疗。

[Objective]To explore the epidemiological changes, clinical characteristics and the strategies of anticoagulation therapy for inpatients with atrial fibrillation （AF）. [Methods]Nine hundred and twenty one inpatients with AF were involved in the present study. [Results]（1）38.8 % patients suffered from valvar AF and 61.2% patients with non-valve AF, most of whom got from hypertension, coronary artery disease, and idiopathic atrial fibrillation and dilated cardiomyopathy. （2）30.3 % patients were senile （aged above 70 years old）, and older patients suffered AF more easily. （3）All patients took the ultrasonic record on left atrium, 71.9 % of them had an enlarged left atrium, and 21.4% of them had a decreased left ventricle ejection fraction （LVEF）. There was a significant difference in the enlarged left atrium between the two groups （ P 〈0.01）. （4）All inpatients accepted aspirin therapy and 8.3 % of them accepted warfarin therapy. [Conclusion]Senium and hypertension are the most common causes of atrial fibrillation, so it is very important to utilize warfarin.