不同年龄段非瓣膜病心房纤颤的临床特点与预后分析

目的 了解各年龄段非瓣膜病心房纤颤(NVAF)患者的病因分布,脑卒中发生率以及心房纤颤类型对脑卒中的影响.方法 对329例NVAF患者进行随访调查.按年龄分为A组(≤60岁)、B组(61～70岁)、C组(71～80岁)、D组(>80岁)4组,调查各组的临床特点及预后.结果 NVAF各年龄组患者的首要病因均为冠心病;A、B组的甲状腺机能亢进性心脏病的病因构成均明显高于C、D组(P＜0.05).各年龄组患者的脑卒中发生率分别为21.79%、26.61%、35.85%和50.00%,脑卒中发生率有随年龄增长而增加的趋势(P＜0.05).对不同NVAF患者的缺血性脑卒中发生率按年龄因素进行分层分析,仅A组有统计学意义(P＜0.05).结论 冠心病是NVAF各年龄组的首要病因;脑卒中的发生随年龄的增加而增长;持续性和阵发性心房纤颤类型在年龄≤60岁的年龄组患者脑卒中发生率间有明显差异.

Clinical Features and Prognosis of Nonvalvular Atrial Fibrillation in Different Age Stages

Objective To explore the incidence of stroke and relative factors in patients of different age groups with non-valvular atrial fibrillation(NVAF).Methods Totally 329 NVAF patients admitted in our hospital from January 1999 to December 2001 were divided into four groups according to their ages: group A (≤60 years),group B (61 - 70 years),group C (71 - 80 years),and group D (﹥80 years).The etiology,clinical features and prognosis of all four groups were investigated and summarized.Results Coronary heart disease (CHD) remained the leading cause in all groups.Hyperthyroid heart disease accounted a significantly higher proportion in groups A and B than in groups C and D(P＜0.05).The incidence of stroke was 21.79%,26.61%,35.85%,and 50.00% in groups A,B,C,and D,respectively.It increased along with the increase of age (P＜0.05).The incidence of ischemic stroke were significantly different among different NVAF type strata (P＜0.05) in group A,while no such difference was observed in other three groups (P＞0.05).Conclusion CHD is the main cause of NVAF.Incidence of stroke increases with aging.The incidences of Persistent and paroxysmal atrial fibrillation only differ among NVAF patients younger than 60 years.