本文關(guān)鍵詞： 房顫 社區(qū)研究 抗凝治療　出處：《川北醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的:分析社區(qū)老年人群心房顫動(dòng)(房顫)患者房顫類型、相關(guān)疾病、血栓栓塞危險(xiǎn)評(píng)分情況以及抗血栓治療現(xiàn)狀,為社區(qū)房顫患者的管理提供指導(dǎo)。方法:2013年4月~10月,對(duì)上海市金山區(qū)11個(gè)社區(qū)65歲以上老年人共30643人以整群抽樣調(diào)查設(shè)計(jì)進(jìn)行健康體檢,對(duì)篩查出的1801(5.9%)例房顫患者進(jìn)行橫斷面調(diào)查。由研究者填寫“心房顫動(dòng)現(xiàn)況調(diào)查表”,調(diào)查內(nèi)容包括社會(huì)人口學(xué)情況、一般健康狀況、現(xiàn)病史、既往史、基礎(chǔ)疾病以及以房顫臨床特征為主要內(nèi)容的問卷調(diào)查。共收集1416份有效問卷例。根據(jù)2015年中華醫(yī)學(xué)會(huì)心電生理和起搏分會(huì)房顫卒中風(fēng)險(xiǎn)評(píng)估系統(tǒng)評(píng)分標(biāo)準(zhǔn)對(duì)患者進(jìn)行CHADS2評(píng)分、CHA2DS2-VASc評(píng)分與HAS-BLED出血風(fēng)險(xiǎn)評(píng)分;分析患者接受抗血栓治療情況。結(jié)果:1.社區(qū)老年房顫男女比例為0.98:1,平均年齡76.1±6.4歲�？偦疾÷�5.9%(1801/30643),男性病人房顫患病率高于女性(6.8%:5.1%,P=0.000)。2.房顫病人中,有吸煙史者16.4%、飲酒史者13.7%和家族史者4.4%。3.所有房顫病人中,首診房顫、陣發(fā)性房顫、持續(xù)性房顫、永久性房顫所占比例分別為60.4%、18.6%、8.3%、12.8%。4.房顫病人最常見的合并癥依次為高血壓59.7%、冠心病35.4%、糖尿病9.5%、病竇綜合征2.5%、左心室肥厚2.2%、心力衰竭1.8%、甲亢0.8%、心肌病0.4%和風(fēng)濕性心臟病0.1%。5.CHADS2評(píng)分≥2分房顫患者共592(41.8%)例,僅4.7%接受抗凝治療,27.7%接受抗血小板治療。CHADS2評(píng)分=1分房顫患者共604(42.7%)例,5.3%接受抗凝治療,18.5%接受抗血小板治療。CHADS2評(píng)分=0分房顫患者共220(15.5%)例,6.4%接受抗凝治療,20.0%接受抗血小板治療。CHA2DS2-VASc評(píng)分≥2分房顫患者共1293(91.3%)例,僅5.2%接受抗凝治療,22.9%接受抗血小板治療。CHA2DS2-VASc評(píng)分為1分者共123(8.7%)例,5.7%采用了抗凝治療,19.5%采用了抗血小板治療。結(jié)論:社區(qū)老年房顫患者人群中,首診房顫患者所占比例較大,血栓栓塞危險(xiǎn)評(píng)分≥2分者所占比例大,但接受抗血栓治療比例低。
[Abstract]:Objective: to analyze the types of atrial fibrillation (AF), related diseases, risk score of thromboembolism and current status of antithrombotic therapy in elderly patients with atrial fibrillation (AF) in community. Methods: from April 2013 to October, the management of patients with atrial fibrillation in the community was studied. A total of 30643 people aged over 65 years old in 11 communities in Jinshan District of Shanghai were examined by cluster sampling design. A cross-sectional survey was carried out on the selected 1801 / 5. 9 patients with atrial fibrillation. The questionnaire was filled out by the researcher. The survey included social demographics, general health status, current medical history, and past history. Basic diseases and clinical features of atrial fibrillation. A total of 1416 valid questionnaire cases were collected. The patients were assessed according to the 2015 Chinese Medical Association ECG and pacing Branch risk Assessment criteria for Atrial Fibrillation Stroke. CHADS2 score, CHA2DS2-VASc score and HAS-BLED bleeding risk score were performed. Results: the ratio of male to female was 0.98: 1 with an average age of 76.1 鹵6.4 years. The total prevalence rate of atrial fibrillation in male patients was higher than that in women, and the prevalence rate of atrial fibrillation in male patients was higher than that in female patients. 16.4 had a history of smoking, 13.7% had a history of drinking, and 4.4 had a family history. Among all patients with atrial fibrillation, the first diagnosis was atrial fibrillation, paroxysmal atrial fibrillation, persistent atrial fibrillation. The proportions of permanent atrial fibrillation were 60.4 and 18.60.3and 12.80.The most common complications in patients with atrial fibrillation were hypertension 59.7, coronary heart disease 35.4g, diabetes 9.5, sinus syndrome 2.5g, left ventricular hypertrophy 2.2, heart failure 1.8b, hyperthyroidism 0.880, cardiomyopathy 0.4% and rheumatic heart disease 0.4%. The total number of patients with atrial fibrillation 鈮，

本文編號(hào)：1510924