4490例非瓣膜性心房颤动患者资料的回顾性分析

发布时间：2018-12-06 10:01

【摘要】：目的:分析非瓣膜性心房颤动(房颤)患者一般情况、脑卒中发生情况及目前口服抗凝药物治疗情况。方法:收集新疆地区13家医院2013年10月至2014年10月住院治疗的4490例房颤患者信息,分析患者一般情况、脑卒中发生情况及脑卒中发生高危患者接受口服抗凝药物治疗情况。结果:(1)患者一般资料:研究总共纳入4490例非瓣膜性房颤患者,有22个民族,其中汉族2918人(65%),少数民族1572(35%)人。男性2638人(58.8%),女性1852人(41.2%),65岁的房颤患者1503人(33.5%),65~74岁的房颤患者1441人(32.1%),大于74岁的房颤患者1546人(34.4%)。1950人(43.4%)合并高血压,886人(19.7%)糖尿病,2078人(46.3%)冠心病,681人(15.2%)心力衰竭,949人(21.1%)肺部疾病,203人(4.5%)慢性肝脏疾病,221人(4.9%)慢性肾脏疾病,352人(7.8%)慢性甲状腺疾病,837人(8.6%)脑卒中。(2)脑卒中相关性分析:单纯非瓣膜性房颤组和非瓣膜性房颤合并脑卒中组在民族、年龄、高血压、糖尿病、冠心病、吸烟、饮酒习惯之间存在统计学差异(P0.05)。在性别、心力衰竭、慢性肝脏疾病、慢性肾脏疾病、甲状腺疾病、慢性肺部疾病之间的差异无统计学意义(P0.05)。多因素回归分析提示年龄增加、高血压、冠心病为非瓣膜性房颤患者发生脑卒的独立危险因素,而偶有饮酒为其保护性因素(P0.05)。民族、吸烟习惯、糖尿病与非瓣膜性房颤患者脑卒中发生风险间无明显的相关性(P0.05)。(3)口服抗凝药物治疗情况:非瓣膜性房颤脑卒中高危患者接受抗凝药物人数少(15.8%),大部分人群仍然使用抗血小板药物(47.3%),部分患者未接受抗凝药物(27.2%)。结论:非瓣膜性房颤患者发生脑卒中独立因素有年龄、高血压、冠心病,而偶有饮酒为其保护性因素。脑卒中发生的高危人群的非瓣膜性房颤患者抗凝治疗不足。
[Abstract]:Objective: to analyze the general situation of patients with non-valvular atrial fibrillation (AF), the incidence of stroke and the current status of oral anticoagulant therapy. Methods: 4490 patients with atrial fibrillation were collected from 13 hospitals in Xinjiang from October 2013 to October 2014. The general situation of patients, the incidence of stroke and the high risk of stroke were analyzed. Results: (1) General data of patients: 4490 patients with non-valvular atrial fibrillation were included in the study. There were 22 nationalities, of which 2918 (65%) were Han nationality and 1572 (35%) were ethnic minorities. There were 2638 males (58.8%), 1852 females (41.2%), 1503 patients aged 65 (33.5%), 1441 patients aged 6574 (32.1%). There were 1546 (34.4%) patients with atrial fibrillation over 74 years old, 1950 (43.4%) patients with hypertension, 886 (19.7%) patients with diabetes, 2078 (46.3%) patients with coronary heart disease, 681 (15.2%) patients with heart failure. There were 949 (21.1%) lung diseases, 203 (4.5%) chronic liver diseases, 221 (4.9%) chronic kidney diseases, 352 (7.8%) chronic thyroid diseases. 837 patients (8.6%) had stroke. (2) Stroke correlation analysis: simple non-valvular atrial fibrillation group and non-valvular atrial fibrillation with stroke group in nationality, age, hypertension, diabetes, coronary heart disease, smoking, There was statistical difference between drinking habits (P0.05). There was no significant difference in sex, heart failure, chronic liver disease, chronic kidney disease, thyroid disease and chronic lung disease (P0.05). Multivariate regression analysis showed that age, hypertension and coronary heart disease were independent risk factors for stroke in patients with non-valvular atrial fibrillation, while occasional drinking was the protective factor (P0.05). Nationality, smoking habits, There was no significant correlation between diabetes mellitus and the risk of stroke in patients with non-valvular atrial fibrillation (P0.05). (3). The patients at high risk of non-valvular atrial fibrillation stroke received less anticoagulants (15.8%). Most of the patients still used antiplatelet drugs (47.3%), and some patients did not receive anticoagulants (27.2%). Conclusion: the independent factors of stroke in patients with non-valvular atrial fibrillation are age, hypertension, coronary heart disease, and occasional drinking is the protective factor. Patients with non-valvular atrial fibrillation at high risk of stroke have inadequate anticoagulant treatment.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.75

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