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通过对老年人房颤住院患者的临床资料进行分析,了解老年人房颤的病因、临床特点及其抗凝治疗的现状,现报道如下。1临床资料1.1一般资料收集我科2002—2006年住院的房颤患者150例,年龄65~88岁,其中男98 相似文献
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郑兴平 《安徽卫生职业技术学院学报》2007,6(2):51-52
目的:分析老年人房颤的动态心电图特点及病因.方法:回顾分析300例心电图和临床资料.结果:心电图特点,粗波型房颤87例(29%)(f波振幅>0.10mv)多见于风心病,细波型房颤213例(71%)(f波振幅≤0.10mv)多见于冠心病,同时合并出现长R-R间距(>146ms)189例,143例(47.7%)出现室性早搏.房颤病因:冠心病132例(44%),风湿性心脏病97例(32.3%),脑栓塞38例(12.7%).结论:老年人冠心病和风心病是引起房颤的主要原因,其中细波型房颤多见于冠心病,粗波型房颤多见风心病. 相似文献
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背景 房颤是急性心肌梗塞 (AMI)的常见并发症 ,但它的预后特征较难理解。本研究应用合作性心血管方案 (CCP)的临床数据来判定高龄AMI的病人房颤的发生率 ,与房颤相关的临床因素和它的预后特征。方法 本研究组的研究对象包括 1 994年 1月~ 1 996年 2月期间出院时基本诊断为AMI的 1 0 6 780名老年医疗方案受益者 ,这些病人根据有无发生房颤分类 ;同时调查了房颤与死亡率的联系和院内结局。结果 1 0 6 780名病人中 ,2 36 56名病人在AMI期间患房颤。在这些房颤病人中 ,1 1 51 0名入院时即表现为房颤 ,其余在住院期间进展为… 相似文献
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目的:探讨他汀类药物对心肌梗死后房颤的预防作用。方法:选取2012年1月-2013年12月本院收治的80例急性心梗患者,根据随机数字表法将其分为他汀组和非他汀组各40例。他汀组入院前已规律服用他汀类药物,非他汀组入院前未服用过他汀类药物,对两组患者进行心电监测,观察心梗后房颤的发生率及阵发性房颤再发生率。结果:他汀组的房颤发生率10.0%明显低于非他汀组的22.5%,且阵发性房颤再发生率33.3%明显低于非他汀组的66.67%,差异均有统计学意义(P〈0.05)。结论:他汀类药物能有效降低MI后房颤的发生率,且有利于预防阵发性房颤的再发生,有效预防阵发性房颤发展为永久性房颤。 相似文献
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任素卿 《解放军保健医学杂志》2001,3(3):180-181
老年病人心血管疾病逐年增多。院前急救已成为老年人心血管疾病救治中的重要课题。在基层门诊中老年人房颤及/或伴心力衰竭、心绞痛病人在急诊中尤为多见。 相似文献
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编辑同志:我父亲今年89岁了,有心脏病和脑梗死的病史。近日外出晨练,由于室外气温太低,室内外温差变化快,老人突然发生了晕厥。我们及时拨打120急救电话,将他送往医院。父亲被送到医院时,血压完全测不出来,诊断为房颤。医生说这是一种十分危险的心律失常,后来经过一个多小时的抢救,父亲终 相似文献
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脑血管疾病是老年人最主要的致病病种,其中脑梗死约占全部脑血管疾病的75%.脑梗死的发病降低了老年人的生活质量,甚至因此而致残,给个人、家庭和社会都带来了极大的负担.众所周知,高血压、糖尿病、高血脂、肥胖等是心脑血管疾病主要危险因素.本文收集我院一年的脑梗死病例,并以同时期住院的脑出血病例作对照,观察常见危险因素高血压、高血脂、高血糖以及老年人常见的心律失常心房颤动(房颤)与脑梗死的发病关系,及其在脑梗死发病中的意义. 相似文献
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在慢性呼吸系统疾病中,除了肺癌外,还有一个“致命杀手”——特发性肺纤维化。这是一种慢性间质性肺病,发病隐匿,病情会逐渐加重,很多人发现时就已经到了中晚期,药物用尽也无法逆转,预后比较差。近年来,随着老龄化加深,特发性肺纤维化发病率和死亡率呈升高趋势。中老年人应对该病提高警惕,了解相关知识,如同防治肺癌那样,争取做到早发现、早诊断、早治疗。尽可能的缓解症状,改善生活质量,延缓疾病进展,降低急性加重的风险,延长生存期。 相似文献
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目的分析北京世纪坛医院老年医疗科65岁老年患者医院感染的常见疾病、原因和病原菌分布。方法回顾性分析北京世纪坛医院老年医疗科2009年1-12月收治的206例医院感染的患者的基线资料,根据痰培养、血培养及尿培养的结果,分析老年患者医院感染的原因及病原菌。结果老年患者的医院感染的发生率较高,其中呼吸道感染最多见,共144例(69.9%);其次为泌尿系统感染36例(17.5%);存在2个系统感染的患者20例(9.7%);其他系统感染6例(2.9%);病原菌以铜绿假单胞菌38例(27.9%)和鲍氏不动杆菌25例(18.4%)等非发酵菌多见,其次为耐甲氧西林金黄色葡萄球菌24例(17.6%)和真菌13例(9.6%)。结论老年患者医院感染发生率高,应引起我们的重视;铜绿假单胞菌、不动杆菌属为主要医院感染的革兰染色阴性杆菌;耐甲氧西林葡萄球菌为主要的革兰阳性球菌,同时真菌感染的问题日益严重;故及时行病原菌培养,在临床经验用药效果不理想时根据药敏试验进一步针对性进行抗菌药物的选择非常重要。 相似文献
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目的 探讨合并房颤的慢性心力衰竭治疗进展.方法 以“合并房颤的慢性心力衰竭”、“慢性心力衰竭”、“治疗”等为关键词,查询中国知网、维普网、万方网等网络资料库,对符合搜索条件的文献资料进行总结归纳,探讨合并房颤的慢性心理衰竭的治疗进展.结果 共搜索得到相关文献资料114篇,排除重复、年代久远的文献,共筛选近五年之内的7篇参考文献进行重点分析.结论 合并房颤的慢性心力衰竭治疗原则为:针对病因实施抗心律失常治疗和抗凝治疗.而抗心律失常治疗中的非药物治疗是解决持续性房颤合并慢性心律失常的重要方法. 相似文献
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目的探讨厄贝沙坦联合胺碘酮治疗阵发性房颤的临床效果及安全性。方法将我院阵发性房颤患者60例随机分为观察组和对照组,对照组给予胺碘酮治疗,观察组给予厄贝沙坦联合胺碘酮治疗,评估临床效果。结果治疗后观察组左房内径明显低于对照组,观察组左房内径明显低于治疗前,两者比较差异具有统计学意义(P〈0.05)。治疗后7d观察组转复窦性心律明显高于对照组,两组比较差异具有统计学意义(P〈0.05)。治疗后12个月观察组维持窦性心律明显高于对照组,两组比较差异具有统计学意义(P〈0.05)。两组均未出现明显的药物治疗副反应。结论厄贝沙坦联合胺碘酮治疗阵发性房颤效果好,副作用少,值得应用。 相似文献
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目的观察美托洛尔联合地高辛治疗心力衰竭伴永久性心房颤动患者对心室率及心功能的影响。方法选择我院收治的200例心力衰竭伴永久性心房颤动患者,随机分为两组各100例。常规组给予地高辛治疗,治疗组给予地高辛联合美托洛尔治疗,比较两组的治疗效果。结果治疗后,治疗组的静息心室率、活动后心室率、左室射血分数、NT-proBNP水平均显著优于常规组(P<0.05)。治疗组的治疗优良率为93.00%,显著高于常规组的82.00%(P<0.05);两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论美托洛尔联合地高辛治疗心力衰竭伴永久性心房颤动患者的效果显著,安全性高。 相似文献
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Tim A. Kanters Jasper J. Brugts Olivier C. Manintveld Matthijs M. Versteegh 《Value in health》2021,24(2):236-243
ObjectivesPatients with atrial fibrillation (AF) have rapid and irregular heart rates, increasing the risk of comorbidities and mortality. Next to formal medical care, many patients receive informal care from their social environment. The objective of this study was to examine the well-being and economic burden of providing informal care to patients with AF in the UK, Italy, and Germany.MethodsCaregivers of patients with AF completed an online survey based on the iMTA Valuation of Informal Care Questionnaire, with questions about their caregiving situation, perceived burden of caregiving, and absence from work due to health problems resulting from caregiving. Care-related quality-of-life utilities were calculated using the Care-related Quality of Life instrument and associated tariffs. Societal costs of caregiving were calculated based on the proxy good method.ResultsA total of 585 caregivers participated in this study. On average, caregivers provided 33 hours of informal care per week to patients (SD 29 hours). On a scale from 0 to 10, their self-rated burden was 5.4. The average Care-related Quality of Life utility was 72. Caregivers primarily indicated problems with daily activities, mental health, and physical health. Still, the vast majority of caregivers (87%) derived fulfillment from providing care. Weekly societal costs of caregiving were on average €636. Comorbidities contributed substantially to the caregiver time and burden.ConclusionsCaring for a patient with AF is associated with substantial objective and subjective burden, but also provides fulfillment from being able to care for a loved one. 相似文献
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João Vasco Santos João Pereira Roberto Pinto Pedro Miguel Castro Elsa Azevedo Alberto Freitas 《Value in health》2017,20(8):1083-1091
Background
Atrial fibrillation (AF) is a major risk factor for ischemic stroke (IS). Patients with AF may undergo preventive therapy. Although the AF impact in the clinical burden of IS has been studied, information is lacking in Southern Europe and there are no studies about the impact in potential years of life lost. Moreover, no nationwide or long-term study analyzed the economic burden of IS stratified by AF.Objective
To study the impact of AF in the clinical and economic burden of IS.Methods
We conducted a retrospective study using nationwide administrative data for all public hospitalizations in mainland Portugal from 2000 to 2014. We considered IS hospitalizations stratified by the presence of AF as secondary diagnosis.Results
Of the total 275,173 IS hospitalizations, 22.6% reported AF. The total number of IS hospitalizations increased from 14,836 in 2000 to 19,561 in 2014 (32% increase), with an increase of 138% in the AF group (from 2,411 to 5,727). In-hospital mortality decreased from 13.6% to 11.5% and was consistently higher in the AF group (17.3% vs. 11.1%). Mean charges were also higher in the AF group (€2297 vs. €2191). Age-adjusted potential years of life lost rate was higher in the group without AF (39.6 vs. 7.5).Conclusions
AF-associated IS hospitalizations more than doubled in the studied 15-year period. Also, AF was responsible for higher in-hospital mortality and hospitalization charges. These facts highlight the need for early detection of AF and preventive treatment to limit IS occurrence, its associated burden, and poorer health outcomes. 相似文献18.
目的:了解社区65岁及以上老年房颤患者抗凝治疗和社区随访情况,为进一步规范抗凝治疗提供理论基础和建议.方法:采用回顾性分析方法,入选2017-2018年本社区65岁及以上老年人心电图或动态心电图诊断房颤的166例患者,通过查阅居民电子健康档案、门诊随访和电话随访方式,记录性别、年龄、主要疾病诊断、CHA2DS2-VAS... 相似文献
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目的:房颤是否增加维持性透析患者死亡率尚无定论。我们回顾分析了维持性血液透析患者的房颤发生率,并对其临床相关因素进行了探讨。方法:观察本中心2005年1月到2007年6月维持性血液透析超过3个月的患者,记录他们的年龄,透析方式,房颤发生情况及血红蛋白维持水平。结果:168例患者中,12例新发房颤,发生率为7.14%,年龄大于55岁的患者共90例,房颤发生率为11.45%,显著高于年龄小于55岁的患者。透析龄大于4年的房颤的发生率为11.11%,房颤患者和非房颤患者血红蛋白水平无明显差异。非房颤患者中有25例发生心梗或脑梗,发生率为15.15%,而房颤患者中发生两例脑梗,发生率为16.67%。结论:1.透析患者的房颤发生率高于普通人群;2.随着年龄的增加房颤的发病率增加,55岁以上的房颤发病率明显升高;3.随着透析年限的增加房颤的发病率也增加,血液透析4年以上房颤的发病率明显升高。 相似文献
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《Journal of the American Medical Directors Association》2021,22(10):2190-2195
ObjectivesAngiotensin-converting enzyme inhibitors (ACEi) and angiotensin-receptor blockers (ARB) have shown antiarrhythmic effects that are useful as part of the upstream therapy for atrial fibrillation (AF), both for primary and secondary prevention. Nevertheless, the potential prognosis value of these drugs in terms of mortality and major cardiovascular events is unclear, especially in older population with AF. Scientific evidence is scarce in this population and shows contradictory results. The aim of this study was to assess the potential benefit of ACEi and ARB in terms of mortality and major cardiovascular outcomes (hospitalization for heart failure, acute myocardial infarction and stroke) in older patients with AF, based on a real-world data analysis.DesignObservational: analysis of a retrospective registry.Settings and ParticipantsThe study included 9365 patients of 75 years or older diagnosed with AF, from CardioCHUVI-AF_75 registry: ClinicalTrials.gov Identifier: NCT04364516. Date of registration: November 26, 2018.MethodsWe performed propensity score matching techniques to obtain 2 comparable groups of 3601 patients with and without ACEi or ARB treatment. We compared survival and cardiovascular outcomes in both groups of patients using Cox proportional hazards models.ResultsWe did not find significant differences in terms of survival between using or not using ACEi or ARB for the older population (hazard ratio for mortality: 0.959, 95% confidence interval 0.872–1.054). There were no significant differences regarding cardiovascular major events between the 2 groups.Conclusions and ImplicationsTreatment with ACEi or ARB did not improve outcomes in terms of survival and cardiovascular events in older patients with AF. These results should prompt the conduct of randomized clinical trials specifically in the older AF patient population to robustly address this issue. 相似文献