某院门诊心房颤动患者抗凝治疗及影响因素分析  

Anti-Coagulant Therapy in Outpatient Patients with Atrial Fibrillation and Its Influencing Factors in a Hospital

作　　者：钟丽球[1] 蒙光义[1] 梁河[1] 黎艺毅 卢少欢 ZHONG Liqiu;MENG Guangyi;LIANG He;LI Yiyi;LU Shaohuan(The First People's Hospital of Yulin,Yulin,Guangxi,China 537000)

机构地区：[1]广西壮族自治区玉林市第一人民医院,广西玉林537000

出　　处：《中国药业》2023年第9期124-128,共5页China Pharmaceuticals

基　　金：广西玉林市科学研究与技术开发计划项目[玉市科201912002]。

摘　　要：目的调查某院门诊心房颤动(简称房颤)患者的抗凝治疗情况,并探讨其抗凝治疗的影响因素。方法应用合理用药监测系统及门诊病历系统收集医院门诊2018年1月至12月收治的房颤患者的临床资料,了解抗凝治疗情况,采用CHA2DS2-VASc评分法评估非瓣膜性房颤患者的卒中风险,采用Logistic回归分析法分析影响抗凝治疗的相关因素。结果共纳入851例患者。其中,男466例(54.76%),女385例(45.24%);平均年龄(66.4±12.4)岁;瓣膜性房颤164例(19.27%),非瓣膜房颤687例(80.73%);合并症排名前3的依次为心力衰竭(478例,56.17%),高血压(346例,40.66%),冠状动脉粥样硬化性心脏病(273例,32.08%)。总体抗凝治疗率为62.28%(530/851),单纯抗血小板治疗率为17.86%(152/851),47.74%(253/530)的患者选择新型口服抗凝药。800例卒中中、高危房颤患者中,502例(62.75%)接受抗凝治疗。Logistic回归分析结果显示,≥75岁、合并冠状动脉粥样硬化性心脏病、服用抗血小板药物为降低抗凝治疗率的影响因素(P<0.05);房颤射频消融术后、瓣膜性房颤、卒中病史为提高抗凝治疗率的影响因素(P<0.05)。结论该院门诊房颤患者抗凝治疗率较低,应针对相关影响因素采取有效干预措施,以提高抗凝治疗率。Objective To investigate the status of anti-coagulant therapy of outpatients with atrial fibrillation(AF),and to explore the related influencing factors of anticoagulant therapy.Methods The clinical data of patients with AF admitted to the outpatient department from January to December 2018 were searched through the prescription automatic screening system(PASS)and outpatient medical record system.The anti-coagulation therapy status of patients with AF was analyzed,the CHA2DS2-VASc scoring method was used to evaluate the stroke risk of patients with non-valvular atrial fibrillation(NVAF),and Logistic regression analysis was used to analyze the related influencing factors of anti-coagulant therapy.Results A total of 851 patients were enrolled in this study.Among them,there were 466 males(54.76%)and 385 females(45.24%).The average age of patients was(66.4±12.4)years old.A total of 164 cases(19.27%)of valvular atrial fibrillation(VAF)and 687 cases(80.73%)of NVAF.The top three concomitant diseases were heart failure(478 cases,56.17%),hypertension(346 cases,40.66%),and coronary heart disease(273 cases,32.08%).The overall rate of anti-coagulant therapy was 62.28%(530/851),and the antiplatelet therapy rate was 17.86%(152/851).About 47.74%(253/530)of patients chose new oral anti-coagulants(NOAC).Among 800 stroke patients with moderate to high-risk AF,502 cases(62.75%)received anti-coagulant therapy.Logistic regression analysis showed that age≥75 years old,combined coronary heart disease,and administration of anti-platelet drugs were the influencing factors to reduce the rate of anti-coagulant therapy(P<0.05).Radiofrequency ablation of atrial fibrillation,valvular atrial fibrillation,and a history of combined stroke were the influencing factors for improving the anti-coagulant therapy rate(P<0.05).Conclusion The anti-coagulant therapy rate of patients with AF in the outpatient department of this hospital is relatively low,and effective intervention measures should be taken based on related influencing factors to improve

关 键 词：心房颤动 抗凝治疗 影响因素 门诊 

分 类 号：R95[医药卫生—药学] R973