香港沙田区1629例心房颤动患者临床特征分析

Clinical features of the patients with atrial fibrillation:1629 cases in Shatian District of Hongkong

目的总结香港沙田地区住院心房颤动患者的临床特征。方法对香港沙田区2007-2009年心房颤动住院患者1 629例进行回顾性分析。结果 (1)心房颤动的类型以阵发性房颤多见,其次为永久性房颤,再次为持续性房颤;(2)心房颤动患者最常见伴随的相关疾病为高血压病(占50.6%),其次为糖尿病者,再依次为冠心病、瓣膜病等;(3)心房颤动患者其抗凝抗栓药物应用较低,卒中风险评分CHA2DS2-VASc≥2分者,华法林应用率只有24.3%,其华法林的国际标准化比率(INR)达标率为30.0%;患者在卒中风险评分中,评分≥2分者与评分≤1分者,在接受华法林的应用方面,前者明显高于后者(P<0.05);(4)心房颤动患者其心室率控制的药物以B-R阻滞剂(倍他乐克)最多,其后依次为洋地黄类、第Ⅲ类抗心律失常药、第Ⅰ类抗心律失常药。结论香港沙田地区心房颤动住院患者高卒中风险者(CHA2DS2-VASc≥2分)抗凝应用率较低,但比分数<2分者高,达标率相对较高;其相关疾病主要有高血压、糖尿病、冠心病;心室率控制方面以B-R阻滞剂应用最多。

Objective To analyze the clinical features of atrial fibrillation in Shatian District of Hongkong. Methods1629 hospitalized patients with atrial fibrillation Shatian District of Hongkong from 2007 to 2009 were retrospectively analyzed. Results（1） For the types of atrial fibrillation, the most frequently was the paroxysmal atrial fibrillation, followed by permanent atrial fibrillation and persistent atrial fibrillation;（2） For the concomitant diseases in the patients with atrial fibrillation, the most frequently was hypertension（50.6%）, followed by diabetes, coronary heart disease, valvular diseases and etc;（3） The application rate of the anticoagulant and antithrombotic drugs in the patients with atrial fibrillation was low. For those with the CHA2 DS2-VASc of ≥2 points, the application rate of warfarin was only 24.3% and the success rate of INR of warfarin was 35.4%; the patients with a stroke risk score of ≥2 points had an application rate of warfarin significantly higher than those with a stroke risk score of ≤1 points（P〈0.05）;（4） For the drugs for the control of ventricular rate applied in the patients with atrial fibrillation, the most frequently used was B-R blockers（betaloc）, followed by digitalis, Class III antiarrhythmic drugs and Class I anti-arrhythmic drugs. Conclusion The patients with atrial fibrillation in Shatian District of Hongkong having a high stroke risks（CHA2 DS2-VASc of ≥ 2 points） have a low application rate of anticoagulant, but their successful rate is relatively higher than those with the CHA2 DS2-VASc of 2 points; the relevant diseases are mainly hypertension, diabetes and coronary heart disease; for the control of ventricular rate, B-R blockers are used the most.