CHADS2评分法规范老年非瓣膜性房颤治疗研究

Study of Standardized Anticoagulant Therapy in Elderly Patient with Atrial Fibrillation

目的:了解老年非瓣膜性心房颤动患者规范化抗凝治疗现状,分析影响规范化抗凝治疗的因素。方法:调取2013年1-12月份曲靖市第一人民医院住院诊断为非瓣膜性心房颤动的老年患者病历,采用CHADS2评分法评价其规范化抗凝情况。结果:共入选患者161例。按照CHADS2评分法将入组患者分组,其中评分≥1患者151例中,进行规范华法林抗凝治疗的仅26例,抗凝结果 11例INR在目标范围内,达到华法林抗凝目标INR值的为42.3%。结论:老年非瓣膜性心房颤动患者进行规范抗凝治疗的比例低(38.4%),其中评分≥2患者中使用华法林进行规范治疗的比例很低(19.8%),针对房颤患者规范化抗凝治疗率低的状况,分析发生原因,采取有效的干预措施,提高老年房颤患者规范化抗凝治疗率、控制率。

Objective：To understand current the state of standardized anticoagulant therapy.In elderly patient with atrial fibrillation and analyze the factors that affect standard anticoagulant therapy,and at the same time,to make progress by the foundation of corresponding countermeasures.Method：Diagnosed nonvalvular atrial fibrillation elderly patients were history inspected for a period of 12 months（from January 2013 to December 2013）in 1st Hospital Cardiovascular Department,CHADS2 scheme method was used to stratify atrial fibrillation elderly patient and assess their risk of bleeding,the standardized anticoagulant therapy conditions were evaluated according to atrial fibrillation treatment guidelines.Result：A total of 161 patients were enrolled.According to the CHADS2 scheme,106 patients were divided into the high risk group,in which only 21 were on warfarin anticoagulant treatment.Among which 11（42.3%） had international normalized ratio（INR）in therapeutic range（2.0-3.0）.Conclusion：The percentage of standard anticoagulant treatment in elderly patients with atrial fibrillation is very low（38.4%）,still more,the percentage of high risk patients using warfarin standard anticoagulant treatment is even low 19.8%.Further investigation and understanding of the causes of this phenomenon will help intervene effectively and improve the standard of anticoagulant therapy in patient with atrial fibrillation.