上海农村心房颤动患者抗栓治疗现况调查

Survey of antithrombotic treatment in rural atrial fibrillation patients in Shanghai

目的:调查当前上海市农村心房颤动(atrial fibrillation,AF)患者的抗栓治疗情况。方法:通过横断面调查上海市松江区60岁以上农村居民36 734人,共筛查出828例AF患者,针对AF患者进行抗栓药物使用情况调查。结果:完成调查的622例AF患者中,有380例(61.09%)未接受任何抗栓治疗;其余242例患者(38.91%)当前正使用抗栓药物,包括阿司匹林(29.58%)、华法林(5.95%)、氯吡格雷(2.89%)、阿司匹林联合氯吡格雷(0.48%)。98.40%的AF患者的CHA2DS2-VASc评分≥1分,其中1分者为11.74%,2分者为25.40%,3分者为27.33%,4分者为19.45%,5分者为9.97%。72.03%AF患者为HAS-BLED评分<3分。对AF患者的脑卒中危险(CHA2DS2-VASc)和抗凝出血风险(HAS-BLED)进行联合评价,59.16%AF患者的CHA2DS2-VASc评分≥2分且HAS-BLED评分<3分。结论 :60岁以上农村AF患者存在严重抗栓治疗不足。

Objective To investigate the status of antithrombotic treatment in rural atrial fibrillation （AF） patients in Shanghai. Methods A cross-sectional survey was conducted among 36 734 rural residents aged 60 and over in Songjiang District Shanghai, and 828 patients with AF were identified. The use of antithrombotic agents was investigated in patients with AF who agreed to undergo questionnaire survey. Results Of the 622 surveyed AF patients, 380 （61.09%） did not re- ceive any antithrombotic therapy, and the other 242 （38.91%） patients currently received antithrombotic drugs, including aspirin （29.58%）, warfarin （5.95%）, clopidogrel （2.89%）, aspirin combined with clopidogrel （0.48%）. None of the patients received new oral anticoagulants. Of the AF patients, 98.40% had CHA2DS2-VASc score ≥1, including CHA2DS2-VASc score 1 in 11.74%, 2 in 25.40%, 3 in 27.33%, 4 in 19.45% and 5 in 9.97%. 72.03% of AF patients had HAS-BLED score〈3. Conclusions Serious insufficiency in antithrombotic therapy was existed in rural AF patients over 60 years old, inspite of most of them had low risk of bleeding and high risk of cardiogenic embolism.