重庆涪陵地区非瓣膜性房颤患者流行病学特征及抗栓治疗现状调查

Investigation on the Epidemiological Characteristics and Antithrombotic Therapy Status of Patients with Non-Valvular Atrial Fibrillation in Fuling Area of Chongqing

目的规范化管理非瓣膜性房颤(NVAF)患者的抗栓治疗。方法调取医院2014年1月至2017年12月诊断为NVAF患者的信息,统计并分析其合并症、卒中风险及抗栓治疗现状。结果共收集NVAF患者2967例,平均年龄(73.69±11.13)岁;男1499例,女1468例;合并冠状动脉硬化性心脏病2429例(81.87%),合并高血压1213例(40.88%),合并脑梗死742例(25.01%),合并糖尿病441例(14.86%),合并心力衰竭3例(0.10%);仅接受抗凝治疗271例(9.13%),接受抗血小板(包括单抗和双抗)治疗1204例(40.58%),接受抗血小板+抗凝治疗560例(18.87%),接受姑息治疗932例(31.41%);CHA2DS2-VASc评分在2~5分的共2338例(78.80%),接受抗凝治疗659例(28.19%),接受抗血小板治疗941例(40.25%),采取姑息治疗738例(31.57%)。结论重庆涪陵地区NVAF患者卒中高危风险占比较大,接受抗凝治疗比例较低,大部分患者采用抗血小板替代抗凝治疗。NVAF患者的抗栓治疗急需进行规范化管理,以降低卒中风险。

Objective To standardize the management of antithrombotic therapy in patients with non-valvular atrial fibrillation(NVAF).Methods The general data of patients diagnosed with NVAF in our hospital from January 2014 to December 2017 were collected,and the complications,stroke risk and antithrombotic therapy status were analyzed.Results A total of 2967 patients with NVAF were collected,with an average age of(73.69±11.13)years,1499 cases of males and 1468 cases of females.Among them,2429 cases(81.87%)were complicated with coronary heart disease,1213 cases(40.88%)were complicated with hypertension,742 cases(25.01%)were complicated with cerebral infarction,441 cases(14.86%)were complicated with diabetes and 3 cases(0.10%)were complicated with heart failure,only 271 cases(9.13%)received anticoagulant therapy,1204 cases(40.58%)received antiplatelet therapy(including monoclonal antibody and dual antibody),560 cases(18.87%)received antiplatelet+anticoagulant therapy,932 cases(31.41%)received palliative therapy.The CHA2 DS2-VASc scores of 2338 patients(78.80%)with NVAF were concentrated in 2-5 points of the cases,659 cases(28.19%)received anticoagulant therapy,941 cases(40.25%)received antiplatelet therapy,and 738 cases(31.57%)received palliative treatment.Conclusion The high risk of stroke in patients with NVAF in Fuling area of Chongqing is relatively high,and the proportion of patients receiving anticoagulant therapy is low.Most patients receive antiplatelet therapy instead of anticoagulant therapy.The management of antithrombotic therapy in patients with NVAF needs to be standardized to reduce the risk of stroke.