心房颤动患者临床特征变化的单中心分析

A retrospective survey of changes of clinical etiologies and therapeutic strategies in administered patients with atrial fibrillation from one medical centre

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 To examine trends of the clinical epidemiology of atrial fibrillation（AF） in the Second Hospital of Tianjin Medical University from 1986 through 2006.Methods We assessed the clinical characteristics of in-hospital patients with AF from 1986 to 2006.Results ① 1005 patients with AF were enrolled the study,aged from 15 to 96 years old.The incidence of AF in hospitalized patients increased with aging within the duration of 21 years,but no difference between male and female.②The first cause of AF was changed from rheumatic heart disease to non-valvular heart diseases in recent years.③AF patients complicated stroke were increased from 11.4% to 20.2%,the rate of warfarin use from 1.6% to 6.1% during past 20 years and of aspirin from 1.3% to 87.7%.Conclusion the primary cause of AF was non-valvular heart diseases.The incidences of AF,AF complicated with stroke and aging were increasing,but anticoagulation and antiplatelet therapies were not used enough.