老年社区人群心房颤动的患病率及相关危险因素的调查

摘要

目的 研究心房颤动( AF)的患病率、危险因素及治疗情况. 方法 天津市5家公立福利养老院的社区老年人参加本项研究.收集基本人口学资料、既往史及个人史信息,完善体格检查和12导联心电图检查. 结果 对1 280名社区老年人进行了调查,资料完整可追溯的715名受访者的数据纳入统计分析,年龄为(80. 6 ± 7. 9)岁(57～112岁). AF的患病率为9. 5% (68例),其中男性8. 8% (28例)、女性10. 1% (40例),性别之间无显著性差异(P=0. 55).最常见的合并症依次为高血压、冠心病、脑卒中、高脂血症和糖尿病. AF患者平均CHA2 DS2-VASc评分为4. 3 ± 1. 4.在68例AF患者中只有1例患者接受华法林抗凝治疗,4例接受双联抗血小板治疗(阿司匹林和氯吡格雷),9例接受单联抗血小板治疗(阿司匹林或氯吡格雷),54 例未接受任何抗栓治疗. 结论 AF是中国老年人的常见病.然而,社区老年AF患者治疗的问题十分突出,尤其是抗凝治疗.需要进一步促进健康措施及教育工作来提高人们对AF的认识.%Objective To investigate the prevalence, risk factors and treatment of atrial fibrillation (AF) in community seniors. Methods Seniors in five public welfare resthomes which located in Tianjin were enrolled in this study. Basic demographic data, past medical history, physical examination data and 12-lead electrocardiogram (ECG) were collected. Results Among 1 280 community senior participants, a total of 715 subjects with complete data were finally enrolled into analysis. The mean age was (80. 6 ± 7. 9) years with a range of 57 to 112 years. The prevalence of AF was 9. 5% ( n=68), including 8. 8% (n=28) in male and 10. 1% in females (n=40). There was no statistical difference between two gender groups (P=0. 55). The most common comorbidities included hypertension, coronary heart disease (CHD), stroke, hyperlipidemia and diabetes mellitus (DM). The mean CHA2DS2-VASc score was 4. 3 ± 1. 4 in 68 AF patients. Of the 68 patients with AF, only 1 patient received appropriate anticoagulation therapy with warfarin, while 4 patients received dual antiplatelet therapy ( aspirin and clopidogrel), and 9 patients were prescribed with single antiplatelet therapy ( aspirin or clopidogrel ), 54 patients did not receive any antiplatelet or anticoagulation therapy. Conclusions AF is a common disease for elderly residents in northern of China. However, the treatment for community elderly patients with AF is not satisfied, especially anticoagulation. Further health promotion and education efforts are needed to improve the awareness and management of AF.