心房颤动的流行病学及治疗现状调查

目的:研究心房颤动(AF)的流行病学特征和治疗现状。方法:选择2000年1月-2002年12月期间本院心内科住院的全部AF患者211例,采用回顾性分析方法对其进行调查研究。结果:AF的发生率为同期住院患者4 399例的4.8％,年龄26-84(平均62.53±10.78)岁。与AF相关的病因谱发生明显变化,老龄排列第1位(42.7％),风湿性瓣膜病已由第1位下降至第5位(22.3％)。74.6％的阵发性AF患者接受节律控制治疗,70.8％的持续性AF患者采用心室率控制治疗。最常用且较安全的复律药物是胺碘酮,复律治疗后能稳定维持窦性心律者仅占26.0％。15.6％的AF患者发生缺血性脑卒中,抗凝治疗可使其发生率明显降低(29.3％:8.1％,P<0.01)。结论:非瓣膜性AF的防治应引起临床关注,药物仍是其主要治疗手段,应加强AF的抗凝治疗。

Investigation of the epidemiology and therapeutic status about atrial fibrillation

Objective: To investigate the epidemiologic characteristics and therapeutic status of atrial fibrillation (AF). Methods:A total of 211 patients with AF were scrutinized. Retrospective analysis was made. Results: The total prevalence of AF was 4.8% of 4 399 inpatients in the corresponding period. The etiology of AF had changed significantly that the aged was ranged first (42. 7%), whereas the rheumatic valvular disease was shifted from first to fifth (22. 3%) . The 74. 6% patients of paroxysmal AF were accepted druy or electrical cardioversion, whereas the 70. 8% of persistent AF remained the therapy of heart rate control. Amiodarone was the safer and most efficacious cardioversion medicine. Only 26.0% cases could maintain sinus rhythm stably following cardioversion. The incidence of ischemic stroke was 15.6%, but the use of anticoagulation could reduce it from 29. 3% to 8.1% (P<0. 01). Conclusion: Prevention and treatment of non-valvular AF should be paid clinical attention. Pharmacology approaches remain the mainstay of therapy for AF. Anticoagulation of AF is critical for prophylaxis of embolic events.