老年心房颤动患者社区管理方案

发布时间：2018-10-25 19:31

【摘要】：目的探讨老年心房颤动患者社区管理方案的制定,并评价其有效性和安全性。方法随机选择2个地理上相隔较远的社区,纳入60岁以上心房颤动患者220例,随机分为试验组(109例)与对照组(111例),试验组采取预先制定的心房颤动社区管理方案进行管理,对照组采取常规诊疗方案。随访至少12个月,主要终点指标是心血管疾病入院和心血管死亡的复合指标。结果经过平均22个月的随访,主要终点指标在两组的发生差异显著,试验组(20.1%)低于对照组(33.3%)(RR=0.61,95%CI 0.38~0.96,P=0.03)。心血管入院发生比在试验组和对照组间存在统计学差异(19.3%vs 31.5%,RR=0.61,95%CI 0.38~0.98,P=0.04);心血管死亡在两组间无统计学差异,但是试验组有降低趋势(RR=0.51,95%CI0.05~5.53,P=0.58)。两组间各种出血事件差异无统计学意义(RR=1.02,95%CI 0.15~7.10,P=0.99)。结论心房颤动社区管理方案能够改善老年心房颤动患者心血管疾病入院,并有降低心血管死亡发生的趋势,且不增加患者的出血风险。
[Abstract]:Objective to evaluate the efficacy and safety of community management in elderly patients with atrial fibrillation. Methods 220 patients with atrial fibrillation over 60 years old were randomly selected from two geographically distant communities. They were randomly divided into two groups: the experimental group (109 cases) and the control group (111 cases). The trial group was managed by pre-established community management of atrial fibrillation, while the control group was treated with routine diagnosis and treatment. Follow-up for at least 12 months, the main endpoint was a combination of cardiovascular disease admission and cardiovascular death. Results after an average follow-up of 22 months, there was a significant difference between the two groups in the occurrence of the main endpoints, which was significantly lower in the trial group (20.1%) than in the control group (33.3%) (RR=0.61,95%CI 0.380.96P0. 03). There was significant difference in the incidence of cardiovascular disease between the trial group and the control group (19.3%vs 31.5). There was no significant difference in cardiovascular death between the two groups, but there was a decreasing trend (RR=0.51,95%CI0.05~5.53,P=0.58) in the trial group. There was no significant difference in various bleeding events between the two groups (RR=1.02,95%CI 0. 15, 7. 10, P 0. 99). Conclusion the community management program of atrial fibrillation can improve the admission of cardiovascular disease in elderly patients with atrial fibrillation and reduce the risk of cardiovascular death without increasing the risk of hemorrhage.
【作者单位】：成都中医药大学;自贡市第一人民医院;四川省人民医院;
【基金】：四川省卫生厅科研课题(No.120004) 四川省医学会“施慧达”科研课题(No.SHD11-02)
【分类号】：R541.75

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