【摘要】：目的:分析非瓣膜性心房顫動(dòng)(房顫)患者一般情況、腦卒中發(fā)生情況及目前口服抗凝藥物治療情況。方法:收集新疆地區(qū)13家醫(yī)院2013年10月至2014年10月住院治療的4490例房顫患者信息,分析患者一般情況、腦卒中發(fā)生情況及腦卒中發(fā)生高�；颊呓邮芸诜鼓幬镏委熐闆r。結(jié)果:(1)患者一般資料:研究總共納入4490例非瓣膜性房顫患者,有22個(gè)民族,其中漢族2918人(65%),少數(shù)民族1572(35%)人。男性2638人(58.8%),女性1852人(41.2%),65歲的房顫患者1503人(33.5%),65~74歲的房顫患者1441人(32.1%),大于74歲的房顫患者1546人(34.4%)。1950人(43.4%)合并高血壓,886人(19.7%)糖尿病,2078人(46.3%)冠心病,681人(15.2%)心力衰竭,949人(21.1%)肺部疾病,203人(4.5%)慢性肝臟疾病,221人(4.9%)慢性腎臟疾病,352人(7.8%)慢性甲狀腺疾病,837人(8.6%)腦卒中。(2)腦卒中相關(guān)性分析:單純非瓣膜性房顫組和非瓣膜性房顫合并腦卒中組在民族、年齡、高血壓、糖尿病、冠心病、吸煙、飲酒習(xí)慣之間存在統(tǒng)計(jì)學(xué)差異(P0.05)。在性別、心力衰竭、慢性肝臟疾病、慢性腎臟疾病、甲狀腺疾病、慢性肺部疾病之間的差異無統(tǒng)計(jì)學(xué)意義(P0.05)。多因素回歸分析提示年齡增加、高血壓、冠心病為非瓣膜性房顫患者發(fā)生腦卒的獨(dú)立危險(xiǎn)因素,而偶有飲酒為其保護(hù)性因素(P0.05)。民族、吸煙習(xí)慣、糖尿病與非瓣膜性房顫患者腦卒中發(fā)生風(fēng)險(xiǎn)間無明顯的相關(guān)性(P0.05)。(3)口服抗凝藥物治療情況:非瓣膜性房顫腦卒中高�；颊呓邮芸鼓幬锶藬�(shù)少(15.8%),大部分人群仍然使用抗血小板藥物(47.3%),部分患者未接受抗凝藥物(27.2%)。結(jié)論:非瓣膜性房顫患者發(fā)生腦卒中獨(dú)立因素有年齡、高血壓、冠心病,而偶有飲酒為其保護(hù)性因素。腦卒中發(fā)生的高危人群的非瓣膜性房顫患者抗凝治療不足。
[Abstract]:Objective: to analyze the general situation of patients with non-valvular atrial fibrillation (AF), the incidence of stroke and the current status of oral anticoagulant therapy. Methods: 4490 patients with atrial fibrillation were collected from 13 hospitals in Xinjiang from October 2013 to October 2014. The general situation of patients, the incidence of stroke and the high risk of stroke were analyzed. Results: (1) General data of patients: 4490 patients with non-valvular atrial fibrillation were included in the study. There were 22 nationalities, of which 2918 (65%) were Han nationality and 1572 (35%) were ethnic minorities. There were 2638 males (58.8%), 1852 females (41.2%), 1503 patients aged 65 (33.5%), 1441 patients aged 6574 (32.1%). There were 1546 (34.4%) patients with atrial fibrillation over 74 years old, 1950 (43.4%) patients with hypertension, 886 (19.7%) patients with diabetes, 2078 (46.3%) patients with coronary heart disease, 681 (15.2%) patients with heart failure. There were 949 (21.1%) lung diseases, 203 (4.5%) chronic liver diseases, 221 (4.9%) chronic kidney diseases, 352 (7.8%) chronic thyroid diseases. 837 patients (8.6%) had stroke. (2) Stroke correlation analysis: simple non-valvular atrial fibrillation group and non-valvular atrial fibrillation with stroke group in nationality, age, hypertension, diabetes, coronary heart disease, smoking, There was statistical difference between drinking habits (P0.05). There was no significant difference in sex, heart failure, chronic liver disease, chronic kidney disease, thyroid disease and chronic lung disease (P0.05). Multivariate regression analysis showed that age, hypertension and coronary heart disease were independent risk factors for stroke in patients with non-valvular atrial fibrillation, while occasional drinking was the protective factor (P0.05). Nationality, smoking habits, There was no significant correlation between diabetes mellitus and the risk of stroke in patients with non-valvular atrial fibrillation (P0.05). (3). The patients at high risk of non-valvular atrial fibrillation stroke received less anticoagulants (15.8%). Most of the patients still used antiplatelet drugs (47.3%), and some patients did not receive anticoagulants (27.2%). Conclusion: the independent factors of stroke in patients with non-valvular atrial fibrillation are age, hypertension, coronary heart disease, and occasional drinking is the protective factor. Patients with non-valvular atrial fibrillation at high risk of stroke have inadequate anticoagulant treatment.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R541.75

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本文編號(hào)：2365860