非瓣膜性心房颤动住院患者抗凝治疗现状调查

Investigation of anticoagulant therapy in hospitalized patients with nonva-lvular atrial fibrillation

目的调查县级医院非瓣膜性心房颤动住院患者抗凝治疗现状,以更好地指导心房颤动抗凝治疗。方法回顾性分析和统计2016年1月~2017年6月在长寿区中医院住院的非瓣膜性房颤患者的住院病历。对纳入病例应用CHA_2DS_2-VASc评分进行卒中风险分层和HAS-BLED评分进行出血风险分层评价规范化抗凝情况;并电话调查未抗凝治疗的原因。结果共186例患者纳入本研究,CHA_2DS_2-VASc评分≥2分有抗凝指征148例(79.6%),抗凝治疗16例(8.6%);抗血小板治疗138例(74.2%);卒中高危患者中未抗凝治疗的主要原因为医生因素占81.6%。结论县级医院非瓣膜性心房颤动患者抗凝治疗率较低,以抗血小板为主,医生因素是患者未抗凝治疗的主要原因。

Objective To investigate the current status of anticoagulant therapy in hospitalized patients with nonvalvular atrial fibrillation in county-level hospitals so as to better guide anticoagulation therapy of atrial fibrillation. Methods The case history of nonvalvular atrial fibrillation patients hospitalized in Changshou District Chinese Medicine Hospital from January 2016 to June 2017 was retrospectively and statistically analyzed. Stroke risk stratification was performed in the included cases using the CHA2DS2-VASc score and the bleeding risk stratification was assessed using HAS- BLED score, to evaluate normalized anticoagulation. And the cause of non-anticoagulant therapy was investigated by telephone. Results A total of 186 patients were enrolled in this study. There were 148 patients（79.6%） who had antico- agulation indications with CHAEDSE-VASc score〉 2 and 16 patients （8.6%） who underwent anticoagulant therapy. There were 138 patients（74.2%） who underwent antiplatelet therapy. The main cause of non-anticoagulant therapy in high-risk stroke patients was doctor＇s factor（81.6%）. Conclusion The anticoagulant rate of nonvalvular atrial fibrillation in county- level hospitals is very low, with the main treatment of anti-platelet aggregation. The main cause of anticoagulant thera- py is anti-platelet therapy. The doctor＇s factor is the main reason why patients are not treated with anti-coagulation.