上海老年农村人口心房颤动流行病学调查

Epidemiological survey of atrial fibrillation among the elderly population in rural areas of Shanghai

目的调查上海市松江区老年农村人口心房颤动(房颤)患病率情况。方法横断面调查2015年上海市松江区7个乡镇的60岁以上农村居民36734名,分为60岁~、70岁~、80岁~、≥90岁4个年龄组,依据病史及体检心电图筛查房颤患者。对36734名60岁以上农村居民中男性和女性房颤患者整体患病率的比较,对同年龄组男性和女性房颤患病率的比较,对同性别各年龄组间房颤患病率的比较,以及对辽宁省≥65岁农村居民房颤患病率和松江区≥65岁农村居民的房颤患病率比较均采用精确四格表χ^2检验。结果上海市松江区7个乡镇60岁以上36734名农村人口中整体房颤患病率为2.25%(828/36734),其中男性的房颤患病率为2.66%(422/15877),女性的房颤患病率为1.95%(406/20857),男性房颤患病率高于女性,差异具有统计学意义(χ^2=20.704,P<0.001)。按年龄组分类的房颤患病率:在男性,60岁~年龄组为1.42%,70岁~年龄组为3.42%,80岁~年龄组为5.81%,≥90岁年龄组为6.49%(各年龄组间比较差异有统计学意义,χ^2=135.586,P<0.001);在女性,60岁~年龄组为0.86%,70岁~年龄组为2.24%,80岁~年龄组为5.02%,≥90岁年龄组为6.20%(各年龄组间比较差异有统计学意义,χ^2=223.249,P<0.001)。各年龄组的男性与女性房颤患病率比较,60岁~和70岁~年龄组男性房颤患病率高于女性,差异具有统计学意义(1.42%vs0.86%,χ^2=14.050,P<0.05;3.42%vs2.24%,χ^2=18.406,P<0.05)。辽宁省≥65岁农村老年女性的房颤患病率高于上海松江地区≥65岁女性的房颤患病率,差异具有统计学意义(3.1%vs2.04%,χ^2=4.132,P=0.042),两个地区≥65岁农村老年男性间的房颤患病率差异无统计学意义(3.3%vs2.89%,χ^2=0.392,P=0.531)。结论上海市松江区60岁以上农村人口的房颤患病率随年龄增长而升高,且存在显著的性别差异。房颤患病率在我国老年农村人口中可能存在性别差异和地域差异。

Objective To investigate the prevalence of atrial fibrillation (AF) among the elderly population in rural areas of Shanghai.Methods A cross-sectional survey was conducted among 36,734 rural residents over 60 years old in Songjiang District of Shanghai in 2015.Patients with atrial fibrillation were screened by medical history and electrocardiogram.The enrolled subjects were divided into four age groups: 60 years~,70 years~,80 years~,and ≥ 90 years.Comparisons of the prevalence of AF between males and females in 36,734 rural residents over 60 years old,between men and women of the same age group,between different age groups of the same sex,and between rural residents over 65 years old in Liaoning Province and those in Songjiang District were performed by the chi-square test of four-fold table.Results The overall prevalence rate of AF in 36,734 rural residents over 60 years old in Songjiang District of Shanghai was 2.25%. The prevalence rate of AF in males (2.66%) was higher than that in females (1.95%)(χ^2=20.704,P < 0.001). For males,the prevalence rate of AF was 1.42% in the 60 years~ group,3.42% in the 70 years~ group, 5.81% in the 80 years~ group,and 6.49% in the ≥ 90 years group;there was a significant difference among different age groups (χ^2=135.586,P < 0.001).For females,the prevalence of AF was 0.86% in the 60 years~ group,2.24% in 70 years~ group,5.02% in 80 years^group,and 6.20% in the ≥ 90 years group;there was a significant difference among different age groups (χ^2=223.249,P < 0.001).Males had a higher AF prevalence rate than females in both the 60 years~ and 70 years~ groups (1.42% vs 0.86%,χ^2=14.050,P < 0.05;3.42% vs 2.24%,χ^2=18.406,P < 0.05).The prevalence rate of AF in females over 65 years old in Liaoning Province was higher than that in Songjiang District of Shanghai (3.1% vs 2.04%,χ^2=4.132,P=0.042);there was no significant difference about AF prevalence rate between males over 65 years old in these two areas (3.3% vs 2.89%,χ^2=0.392,P=0.531).Conclusion The prevalence of AF increases with age in rural population over 60 years old in Songjiang District of Shanghai,with a significant difference between two sexes.The prevalence of AF in Chinese elderly rural population may have gender and regional differences.