120例心房颤动住院患者抗栓治疗的临床分析

Clinical Analysis of Antithrombotic Therapy in 120 Hospitalized Patients with Atrial Fibrillation

目的回顾分析心房颤动住院患者抗栓治疗情况,初步探讨心房颤动住院患者的病因组成、抗栓治疗现状。方法选择2008年1月～2009年7月住院的心房颤动患者120例,应用ACC/AHA/ESC心房颤动指南血栓栓塞危险分层标准对患者进行危险评估,对其病因、血栓栓塞危险因素、抗血栓药物应用情况及未应用华法林抗凝治疗原因进行分析。结果房颤的病因以冠心病、高血压病、老年退行性心瓣膜病、风湿性心瓣膜病及肺心病为主。对120例患者进行血栓栓塞危险评估,绝大多数合并多种危险因素,符合抗凝指征的患者82例,其中应用华法林者只有18例(21.9%),应用阿司匹林者35例(42.7%),其他抗血小板药物21例(25.6%),未应用抗血栓药物8例(9.7%)。结论冠心病、高血压病、老年退行性心脏瓣膜病等是房颤的主要病因。房颤患者华法林应用率低,依从性差,抗血小板药使用率高,患者抗栓治疗欠规范,需加强医生和患者抗栓治疗重要性和必要性的教育。

Objective To retrospectively analyze the conditions of antithrombotic therapy, to discuss the etiology composition and status of antithrombotic therapy in hospitalized patients with atrial fibrillation. Methods 120 hospitalized patients with atrial fibrillation selected from January 2008 to July 2009 were taken the risk assessment according to the thromboembolic risk stratification standard of ACC/AHA/ESC atrial fibrillation guidelines, the etiology, thromboembolism risk factors, the application of antithrombotic drugs and the causes of non-application of warfarin anticoagulant therapy were analyzed. Results The causes of atrial fibrillation were mainly the coronary heart disease, hypertension, degenerative valvular heart disease, rheumatic heart disease and pulmonary heart disease. In 120 patients with thromboembolism risk assessment, most patients were with multiple risk factors, 82 patients satisfied indications for anticoagulation, includ- ing 18 cases （21.9%） of warfarin application, 35 cases （42.7%） of aspirin application, 21 cases （25.6%） of other antiplatelet drugs application, 8 cases （9.7%） of no anti-clotting drugs application. Conclusion The coronary heart disease, hypertension, degenerative valvular heart disease, etc. are the major causes of atrial fibrillation. The application of warfarin in patients with atrial fibrillation has low and poor compliance, the using rate of anti-platelet drugs is high, due to no specification of antithrombotic therapy, doctors and patients need to enhance the education of importance and necessity of antithrombotic therapy.