1335例心房颤动住院患者病因(或相关因素)分析

目的探讨心房颤动(房颤)住院患者的病因(或相关因素)。方法对我院2000年1月~2005年12月出院时诊断为房颤的1335例患者的临床资料进行回顾性分析。结果(1)入选患者1335例,年龄为19~101(68.7±11.9)岁,男女比例为1.31∶1,阵发性、持续性、永久性房颤分别为54.7%、10.6%、34.7%。(2)房颤病因(或相关因素)统计:老年70%,高血压57.3%,冠心病26.3%,风湿性心脏病12.8%,糖尿病19.8%,贫血18.6%。54.1%合并有心房扩大,12.6%有左心室射血分数下降。<45岁年龄组的首位病因(或相关因素)为风心病,而≥45岁年龄组为高血压。(3)随着高血压病程延长,房颤发生增加,但左心房内径无进一步增加。(4)房颤患者左心房前后径为阵发性房颤<持续性房颤<永久性房颤[(38.81±7.69)mm<(43.55±8.05)mm<(48.05±10.33)mm,P<0.05]。(5)随着房颤病程的延长左心房前后径增加[<5年:(39.98±8.05)mm,5~10年:(44.18±10.84)mm,>10年:(46.17±10.63)mm,P<0.05]。结论老年和高血压是房颤最常见的病因(或相关因素),应积极控制高血压,减少或延缓房颤的发生、发展。

Analysis of etiological or associated factors in 1 335 hospitalized cases of atrial fibrillation

Objective To analyze the etiological or associated factors of atrial fibrillation in patients. Method The clinical data of atrial fibrillation patients hospitalized in this hospital during 2000～2005 were analyzed retrospectively.Results (1) A total of 1335 patients (male:female,1.31∶1) were enrolled in the study with ages of 19～101(68.7±11.9) years.The percentages of paroxysmal, persistent and permanent atrial fibrillation were 54.7%, 10.6% and 34.7% respectively. (2) The etiological or associated factors of atrial fibrillation derived from the study were as follows: 70% was aging, 57.3% was hypertension, 26.3% was coronary heart disease, 19.8% was diabetes mellitus, 18.6% was anemia and 12.8% was rheumatic heart disease. The main etiological or associated factor in patients aged <45 years was rheumatic heart disease,but in patients ≥45 years, hypertension was the primary factor. (3)The incidence of atrial fibrillation increased with prolonging the course of hypertension without further enlargement of the left atrium. (4)The anterior-posterior diameter of the left atrium increased as atrial fibrillation proceeded from paroxysmal to persistent and further to permanent (38.81±7.69 mm<43.55±8.05 mm<48.05±10.33 mm,P<0.05) and also increased proportionally to the course of the disease:(39.98±8.05) mm in cases <5 years, (44.18±10.84) mm in cases of 5～10 years and (46.17±10.63) mm in cases >10 years (P<0.05). Conclusion Senium and hypertension are the most common causes of atrial fibrillation, so it is very important to control blood pressure for reducing atrial fibrillation development.