老年非瓣膜心房颤动及合并脑梗死住院患者抗栓治疗调查

目的探讨老年非瓣膜性心房颤动(NVAF)及合并脑梗死住院患者的临床特征、栓塞和出血风险及抗栓治疗现状。方法回顾分析583例非瓣膜老年心房颤动患者(≥60岁)的临床资料,分别应用CHADS2评分及CHA2DS2-VASc评分进行卒中风险分层,比较两种评分系统对卒中风险评估的差异,分析探讨各分层抗栓药物应用情况,并应用HAS-BLED评分进行出血风险评估。结果所有NVAF患者基础病中以高血压最常见占61.3%,其次冠心病占56.2%。583例NVAF心房颤动患者中,CHADS2评分≥2分351例,华法林用药率为2.6%,抗血小板用药率为82.3%,CHA2DS2-VASc评分≥2分522例,华法林用药率为2.1%,抗血小板用药率为84.7%。结论高血压和冠心病是大多数老年心房颤动患者的基础疾病,老年心房颤动及合并脑梗死患者应用华法林进行规范化抗凝治疗的比例低。

A survey of antithrombotic therapy for the elderly inpatients complicated with non valvular atrial fibrillation and cerebral infarction

Objective In order to investigate the clinical characteristic,risk of embolism and bleeding,and the antithrombotic therapy for the elderly inpatients complicated with non valvular atrial fibrillation （NVAF）and cerebral infarction.Methods 583 elderly patients（≥60years old）with NVAF were categorized by the risk of stroke （CHADS2 Score and CHA2DS2-VASc Score）and bleeding （HAS-BLED Score）.The effect of antithrombotic treatment in different risk categories was analyzed.Results The most common diseases was hypertension（61.3%）,followed by coronary heart disease（56.2%）.Among 583 NVAF patients,351 patients had a CHADS2 Score of≥2,of which 2.6% patient were prescribed with warfarin and 82.3% with antiplatelet.522 patients had a CHA2DS2-VASc Score of≥2,of which 2.1% patient were prescribed with warfarin and 84.7% with antiplatelet.Conclusion Coronary heart disease and hypertension are the common diseases in most elderly patients with AF.The proportion of standardized anticoagulant therapy for elderly patients with NVAF is very low.