摘要
目的了解近8年心房颤动(简称房颤)的病因变化和治疗策略转变情况,为临床防治提供参考。方法回顾性分析1998年1月至2005年12月在重庆医科大学附属第二医院心血管内科治疗资料完整的房颤患者839例,与1990年1月至1997年12月的房颤患者694例为对照。结果(1)近年来高血压(34.3%)、冠心病(29.4%)已超过风心病(20.5%)成为房颤的主要病因,老年患者增多(60岁以上者占68.3%)。(2)阵发性房颤多采用复律治疗(51.4%),药物多为胺碘酮(67%)、心律平(24%)。(3)慢性房颤治疗以控制心室率(76%)为主,药物选择为洋地黄类(39%)、β-受体阻滞剂(36%)、钙拮抗剂(25%),有不足1/2的持续性房颤患者试行复律。(4)抗血栓治疗以抗血小板为主(77.9%),药物多为阿司匹林,抗凝治疗(华法林)占10.1%。结论近8年来房颤的病因主要为高血压、冠心病,治疗策略以控制心室率为主,对于存在血栓高危因素者应以抗凝治疗为主,目前还存在抗凝治疗强度及剂量不足,控制心室率治疗不规范等问题。
Objective To know changes in etiopathogenisis transmutation and treatment strategy of atrial fibrillation （AF）over the last 8 years and contribute to prevention and cure of AF in clinics. Methods A retrospective study was carried out at our hospital to analyze 839 AF cases from Jan 1998 to Dec 2005 ,and cases from Jan 1990 to Dec 1997 were as comparison. Results （ 1 ） Hypertension （ 34. 3 % ） and coronary artery disease （ 29.4% ） , which surpassed rheumatic disease of the heart（20. 5% ） ,became main etiopathogenisis of AF,and elderly patients were increasing（68.3% over 60 years）. （2） Paroxysmal AF was cured by rhythm control（51.4% ）. （3） Chronic AF was treated by rate control（76% ）. （4） 77.9% patients received antithrombotic therapy of antiplatelat agents （aspirin）. Anti-coagulants was only 10. 1%. Conclusion Etiopathogenisis and treatment strategy of atrial fibrillation are highly different from before. But control rate of AF is not very good. Anticoagulant therapy is underdosage and controlling ventricular rate therapy is not standard. Therefore it was advisable to enforce the control of AF.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2007年第19期1517-1519,共3页
Chinese Journal of Practical Internal Medicine
关键词
心房颤动
病因
治疗
回顾分析
Atrial fibrillation
Etiopathogenisis
Treatment
Retrospective analysis
