湖北省心房颤动流行病学的横断面研究

The epidemiology of atrial fibrillation in Hubei province:a cross-sectional study

目的了解湖北省心房颤动(简称房颤)患病率、危险因素、并发症及治疗现状,为房颤预防、管理和治疗提供依据。方法2021年5~9月,采用分层抽样和随机抽样结合的方法调查≥18岁湖北省居民共13078人;调查内容包括心血管病问卷、血压、身高、体重、腰围、臀围和心电图;并对调查结果进行统计学分析。结果本研究共发现房颤203人,其中既往已确诊房颤有146人,新发现房颤57人。与非房颤组比较,房颤组更易合并高血压、糖尿病、高脂血症、冠心病、心力衰竭、心脏瓣膜病、甲状腺功能亢进、肾功能不全、睡眠呼吸暂停综合征、外周血管疾病、吸烟和肥胖(P均<0.05)。房颤患病率为1.6%,年龄标准化患病率为1.1%,男性高于女性(1.8%vs 1.3%),城市高于农村(1.8%vs 0.7%)。二元logistic回归分析发现年龄(AOR=1.798,95%CI:1.597~2.024)、性别(AOR=0.709,95%CI:0.531~0.947)、高血压(AOR=1.651,95%CI:1.219~2.237)、冠心病(AOR=1.938,95%CI:1.337~2.810)、心脏瓣膜病(AOR=5.261,95%CI:2.517~10.998)和心力衰竭(AOR=5.298,95%CI:3.408~8.234)是房颤的危险因素。房颤人群缺血性脑卒中患病率显著高于非房颤人群(8.9%vs 1.7%;P<0.01)。已确诊房颤患者规范治疗人数占比45.9%。结论湖北省房颤患病率低于全国,危险因素与国内外研究相近,但相关治疗情况不容乐观。

Objective To investigate the prevalence,risk factors,complications and treatment present condition of atrial fibrllation(AF)and further to provide evidence for prevention,management and treatment of AF in Hubei Province.Methods 13078 residents aged≥18 years in Hubei Province were investigated by stratified sampling and random samplingduring May to September 2021.The contents of this investigation included cardiovascular disease questionnaire,blood pressure,height,weight,waistline,hipline,and electrocardiogram.The results were statistically analyzed.Results This study identified 203 patients with AF,which including 146 previously diagnosed AF and 57 newly diagnosed AF.Compared with the non-AF group,the AF group was more likely to have hypertension,diabetes,hyperlipidemia,coronary heart disease,heart failure,valvular heart disease,hyperthyroidism,renal insufficiency,sleep apnea syndrome,peripheral vascular disease,smoking and obesity(all P<0.05).The prevalence and age-standardized prevalence of AF was 1.6%and 1.1%respectively.Meanwhile,the AF prevalence in the population of menand city was higher than that in women and country.Binary logistic regression analysis showed that age(AOR=1.798,95%CI:1.597-2.024),gender(AOR=0.709,95%CI:0.531-0.947),hypertension(AOR=1.651,95%CI:1.219-2.237),coronary heart disease(AOR=1.938,95%CI:1.337-2.810),valvular heart disease(AOR=5.261,95%CI:2.517-10.998)and heart failure(AOR=5.298,95%CI:3.408-8.234)were the risk factors for AF.The prevalence of ischemic stroke in patients with AF was significantly higher than that in patients without AF(8.87%vs 1.71%;P<0.01).In addition,the number of patients with confirmed AF receiving standard treatment accounted for 45.9%.Conclusions The prevalence of AF in Hubei Province is lower than that in whole country,and the risk factors are similar to those in domestic and foreign studies.However,the treatment situation of AF in Hubei Province is not optimistic.