875例老年心房颤动患者抗血栓治疗现状分析

摘要

摘要:目的 了解老年心房颤动(房颤)患者抗血栓治疗现状,为老年房颤的治疗提供参考.方法 选择资料完整的老年房颤患者875例,将其中济南军区总医院的445例房颤患者按年龄分为60～74岁158例,75～80岁118例,81～84岁112例,≥85岁57例.回顾性分析所有患者的一般情况、合并疾病、房颤分类及用药情况.结果 所有阵发性房颤治疗以药物复律为主,占61.4％,所有持续性和永久性房颤治疗以控制心室率为主,占80.1％,抗血栓治疗以阿司匹林为主,占77.7％,华法林占14.5％.与60～74岁比较,其他年龄段患者建议服用华法林治疗比例明显升高(P＜0.05),与≥80岁比较,75～80岁、81～84岁患者实际服用华法林治疗比例明显升高(P＜0.05).结论 阵发性房颤使用胺碘酮最多,抗血栓治疗阿司匹林使用普遍,基层医院华法林使用率较低.%Objective To know present situation of antithrombotic treatment in elderly patients with atrial fibrillation(AF). Methods 875 AF cases with complete medical records were selected. Their general condition,complications,atrial fibrillation category and drug use were retrospectively analyzed. 445 patients of General Hospital of Jinan Military Region were classified by age into 158 cases of 60 - 74 years old, 118 cases of 75 - 80 years old, 112 cases of 81 - 84 years old and 57 cases of ≥ 85 years old. Results Paroxysmal AF was treated with rhythm control by drugs (61. 4%),persistent and permanent AF was treated with rate control (80. 1%). The main antithrombotic therapy with aspirin accounted for 77. 7% and anticoagulant therapy (warfarin) accounted for 14. 5%. Compared with 60 - 74 years old patients, the suggesting warfarin therapy proportion in other age groups increased significantly(P<0. 05). Compared with≥80 years old patients,the actual rate of taking warfarin treatment in 75 - 80 years old and 81 - 84 years old patients increased significantly(P<0. 05). Conclusion Amiodarone was used most widely in paroxysmal atrial fibrillation,aspirin was used generally in antithrombotic therapy,while warfarin was rarely used,especially in the primary hospital.