心房纤颤90例临床分析

Clinical analysis of 90 cases with atrial fibrillation

目的:分析心房纤颤(AF)患者的发病年龄与病因、临床特点的关系。方法:对我院2005～2008年住院的90例AF患者按年龄分为老年组(65岁以上)、非老年组(65岁以下),并对其临床资料进行回顾性分析。结果:老年组AF58例(64.4%),前3位病因分别为冠心病24例(41.4%),高血压病10例(17.2%),慢性阻塞性肺疾病6例(10.3%);非老年组AF32例(35.6%),前3位病因分别为风湿性心瓣膜病23例(71.9%),高血压病2例(6.3%),扩张性心肌病2例(6.3%);90例中左房内径增大78例(86.7%),左房血栓形成6例(6.7%),合并心衰38例(42.2%),脑栓塞6例(6.7%)。使用抗凝药物治疗84例(93.4%),其中华法林治疗6例(6.7%),阿司匹林治疗78例(86.7%)。结论:AF发病率随年龄增大而上升,老年组主要病因为冠心病,非老年组主要病因为风心病。AF大部分出现左房增大,心衰是AF的主要并发症。

Objective： To analyze age, etiology and clinical character of patients with atrial fibrillation （AF）. Methods： Divided 90 AF cases during 2005-2008 into two groups based on age： eider group （ 〉65 years old） and non-elder group （ ≤65 years） , and retrospectively analyzed the clinical date. Results： 58 cases in elder group had AF （64.4%） , including 24 cases with coronary artery disease （41.4%） , 10 cases with hypertension （ 17.2% ） and 6 cases with chronic obstructive lung disease （ 10.3% ） ; while 32 cases had AF in non-elder group, including 23 cases with rheumatic valvular disease （71.9%） , 2 cases with hypertension （6.3%） and 2 cases with dilated cardiomyopathy （6.3%）. 78 cases had increased inner diameter of atria sinistrum （86.7%）, 38 cases had heart failure （42.2%）, 6 cases had cerebral embolism （6.7%）, and 6 cases had thrombus in atria sinistrum （6.7%）. 6 cases were treated with Warfarin （6.7%）, and 78 cases with Aspirin （86.7%）. Conclusion： The older patients are, the higher the incidence of AF is. Coronary artery disease is the main etiology in elder group and rheumatic heart disease in non-elder group. Most patients have enlarged atria sinistrum, and heart failure is the main complication.