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上海市社区老年人群心房颤动的流行病学特征及抗凝治疗现状调查

Epidemiological characteristics and anticoagulant therapy status of atrial fibrillation in elderly community residents in Shanghai

  • 摘要: 目的:探讨上海市社区老年人群心房颤动(房颤)的患病类型、相关心血管疾病、血栓栓塞风险及抗凝治疗现状。方法:对2015年4月至2016年5月上海市金山区11个社区65岁以上健康体检诊断为房颤的患者进行横断面调查。由调查者对患者进行12导联常规心电图检查并填写“房颤患者特征评估调查表”。结果:房颤患者共1 368例,平均年龄(76.1±6.4)岁,男性患者占50.4%。首诊房颤、阵发性房颤、持续性房颤、永久性房颤及无法确定房颤类型者分别占39.7%、19.2%、8.6%、13.2%、19.3%。合并高血压59.3%、冠心病35.9%、脑血管疾病10.5%、糖尿病9.5%、慢性阻塞性肺病3.3%、窦房结功能不全/病窦综合征2.3%、左心室肥厚2.2%、心肌梗死2.0%、心力衰竭1.9%。CHASD2评分≥2分的房颤患者共239例,其中16例(6.9%)接受抗凝治疗、57例(24.7%)采用抗血小板治疗;CHA2DS2VASc评分≥2分的房颤患者共471例,29例(6.4%)接受抗凝治疗,96例(21.2%)采用抗血小板治疗。结论:上海市社区老年房颤患者人群中,首诊房颤患者、卒中高危风险者所占比例较大,但接受抗凝治疗比例低。

     

    Abstract: Objective:To evaluate the epidemiological characteristics, thromboembolic risk and current anticoagulant therapy status of atrial fibrillation (AF) in elderly community residents. Methods:A cross-sectional survey of patients with AF on physical examination from April 2015 to May 2016 for people who aged over 65 years old was conducted in 11 communities of Jinshan District, Shanghai. A 12-lead electrocardiogram examination and a research questionnaire of AF were obtained. Results:1 368 patients with AF were enrolled, mean age was (76.1±6.4) years old,male patients accounted for 50.4%.The proportion of first diagnosed,paroxysmal, persistent, permanent, and unknown AF were 39.7%, 19.2%,8.6%, 13.2%, and 19.3%, respectively. The comorbidity (or related diseases) of AF were as follows:hypertension 59.3%, coronary heart disease 35.9%, cerebrovascular diseases 10.5%,diabetes 9.5%, chronic obstructive pulmonary disease(COPD) 3.3%,sick sinus syndrome 2.3%,left ventricular hypertrophy 2.2%,myocardial infarction 2.0%, heart failure 1.9%. 239 patients had CHADS2 score≥2, but the proportion of anticoagulant and antiplatelet therapy were 6.9% and 24.7%. 471 patients had CHA2DS2-VASc score≥2, only 6.4% patients received anticoagulant therapy and 21.2% patients received antiplatelet therapy. Conclusions:The proportion of elderly AF patients with high risk of stroke is higher, but the proportion of patients who received the anticoagulant therapy is lower in the community residents of Shanghai.

     

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