老年心房颤动患病率与缺血性卒中及CHA2DS2-VASc评分的相关性  

Relationship Between Prevalence of Atrial Fibrillation, Ischemia Stoke and CHA2DS2-VASc Score in Elderly Patients

作　　者：王丽[1] 陈庆伟[1] 冯琴[1] 柯大智[1] 李桂琼[1] 

机构地区：[1]重庆医科大学附属第二医院老年心血管科,重庆市400010

出　　处：《中国循环杂志》2017年第5期452-456,共5页Chinese Circulation Journal

基　　金：国家自然科学基金(31271262;31600957);重庆市博士后基金(Xm201351);重庆市渝中区科委项目(20120220);社会事业与民生保障科技创新专项(cstc2016shmszx130036)

摘　　要：目的:探讨老年(≥65岁)心房颤动(房颤)患病率与缺血性卒中及CHA2DS2-VASc评分的相关性,为其临床防治提供依据。方法:采集我院2013-10至2015-10连续住我科5 016例患者的住院资料,房颤患者437例为房颤组,非房颤患者4 579例为非房颤组。按年龄分为<65岁、65~74岁、75~84岁、≥85岁四个年龄段,回顾性分析房颤的危险因素。结果:与非房颤组相比,房颤组患者年龄、男性房颤患者所占比例增加(P均<0.001);合并高血压、冠心病、糖尿病、病态窦房结综合征和风湿性心脏病(风心病)的患者比例显著增高(P均<0.001)。年龄、男性、冠心病、病态窦房结综合征和风心病是房颤发生的独立危险因素。房颤组患者缺血性卒中的患病率和发病年龄均高于非房颤组患者(P均<0.01)。非瓣膜性房颤CHA2DS2-VASc评分≥2分患者所占比例明显高于CHA2DS2-VASc评分<2分的患者(P<0.001),其抗凝治疗率随增龄而下降(P均<0.001)。结论:房颤的发生与年龄、男性、冠心病、病态窦房结综合征和风心病患病率独立相关。非瓣膜性房颤缺血性卒中的发病风险较非房颤者明显增加,需及早开始抗凝治疗。Objective： To explore the relationship between prevalence of atrial fibrillation （AF）, iskhemia stoke and CHA2DS2-VASc score in patients〉65 years in order to provide prevention and treatment basis in clinical practice. Methods： A total of 5016 patients admitted in our hospital from 2013-10 to 2015-10 were enrolled. The patients were divided into 2 groups： AF group, n=437 and Non-AF patients, n=4579; according to age, the patients were further assigned into 4 subgroups as 〈65 years subgroup, （65-74） years subgroup, （75-84） years subgroup and 〉85 years subgroup. The risk factors for AF occurrence were retrospectively studied. Results： Compared with the Non-AF group, the patients in AF group had the elder age and more male gender, both P〈0.001; more patients combining with hypertension, coronary artery disease （CAD）, diabetes, sick sinus syndrome and rheumatic heart disease, all P〈0.001. Age, male gender, CAD, sick sinus syndrome and rheumatic heart disease were the independent risk factors for AF occurrence. Compared with Non-AF group, AF group showed the higher prevalence rate of i schemic stroke and the elder onset age, both P〈0.01. For non-valvular AF, the ratio of patients with CHA2DS2-VASc score〉2 was higher than those with CHA2DS2-VASc score〈2 and the rate of anticoagulant therapy was decreasing by age increasing, all P〈0.001. Conclusion： Age, male gender, CAD, sick sinus syndrome and rheumatic heart disease were independently related to AF occurrence. Non-valvular AF patients had the higher risk for ischemic stroke than non-AF patients, anticoagulation therapy should be conducted at the early stage.

关 键 词：心房颤动 危险因素 卒中 CHA2DS2-VASc评分 

分 类 号：R54[医药卫生—心血管疾病]