106例高龄老年房颤患者的抗栓治疗分析

目的探讨75岁以上高龄老年房颤患者的栓塞及出血风险及目前本院的抗栓治疗现状。方法根据2010年欧洲心脏病学会《房颤治疗指南》中的CHA2DS2．VASe评分标准和HAS．BLED评分标准,对2011年3月-2011年9月在我院老年医疗科病房明确诊断存在心房纤颤、且年龄I〉60岁的老年患者分成〈75岁（老年组）和〉175岁（高龄老年组）两组,对两组患者的相关资料进行对照分析。结果高龄老年组的CHA2DS2-VASe评分（5．65±1．12）和HAS-BLED评分（3．60±0．84）均显著高于老年组（分别为3．55±1．15和2．85±0．81）;两组的抗栓治疗的比例均较低,且有显著差异（51．28％vs62．34％）。结论年龄〉75岁的高龄老年房颤患者存在极高的栓塞及出血双重风险,抗栓治疗的实施率也显著降低。对该类人群的治疗必须依托安全有效的抗栓策略,以改善目前的治疗现状。

Antithrombotic treatment in 106 senile patients with atrial fibrillation

Objective To investigate the status of embolism and risk of bleeding in senile patients with atrial fibrillation who were aged beyond 75-year-old.Methods According to CHA2DS2-VASc and HAS-BLED standards in Guidelines for the Management of Atrial Fibrillation of the European Society of Cardiology(ESC)in 2010,senile patients who were aged≥60-year-old and diagnosed as atrial fibrillation in the department of senile medical treatment between March 2011 and September 2011 were divided into senile group(age<75-year-old)and advanced age group(age≥75),and contrast analysis was made in their data.Results The CHA2DS2-VASc and HAS-BLED scores of the advanced age group were respectively 5.65±1.12 and 3.60±0.84,which were all higher than those of the senile group(3.55±1.15 and 2.85±0.81).The proportion of patients receiving antithrombotic treatment in those groups was very low,and there were significant differences between the two groups(51.28% vs 62.34%).Conclusion There is high double risks of embolism and hemorrhage among patients with atrial fibrillation who are aged beyond 75-year-old.The implementation rate of antithrombotic therapy significantly decreases.The treatment for this population should be based on the safe and effective antithrombotic therapy in order to improve the present treatment situation.