摘要
目的 评估我国非瓣膜病心房颤动（房颤）患者口服华法林抗凝（oral walfarin anticoagulation,OAC）治疗不足的状况并对其影响因素进行分析.方法 本研究为单中心注册研究,入选我院就诊的非瓣膜病房颤患者并登记其一般情况、疾病特征、合并疾患及抗凝治疗等,对患者进行CHA2DS2-VASc风险评分,评估我国房颤患者的抗凝状况并对华法林使用的影响原因进行单因素及多因素分析.结果 全部入选的576例非瓣膜病房颤人群中,有214例（39.4％） OAC治疗,在476例药物治疗（非导管消融）的房颤患者中,144例（30.3％）例使用华法林抗凝.持续性房颤、糖尿病史、慢性心力衰竭史、缺血性卒中/一过性脑缺血发作史、CHA2DS2-VASc评分高者更多使用OAC治疗,合并冠心病的房颤患者由于更多用抗小板药物而较少OAC治疗.在多因素回归分析中,持续性房颤、慢性心衰史、缺血性卒中/一过性脑缺血发作史及非冠心病是使用OAC治疗的预测因子.结论 我国非瓣膜病房颤患者中使用华法林抗凝治疗严重不足,且未能严格遵循血栓栓塞风险评估进行抗凝.
Objective To evaluate the factors responsible for the insufficient application of oral anticoagulation （OAC）in Chinese patients with non-valvular atrial fibrillation. Methods The research is a single center registration study in a tertiary referral hospital in Beijing. The general characteristics, history of atrial fibrillation, comorbidities and anticoagulation treatment were obtained from all patients. Factors affecting the oral Walfarin use were evaluated by univariable and muhivariable regression analysis. Results OAC therapy with Walfarin was applied on Only 214 （ 39. 4% ） out of 576 consecutive patients with non- valvular atrial fibrillation. The OAC rate was 30. 3% among non-ablation patients. Patients with persistent atrial fibrillation, diabetes, chronic heart failure, history of ischemic stroke/TIA and higher CHA2 DS2-VASc score were more likely prescribed with Walfarin. Multivariable regression analysis showed that persistent fibrillation, history of chronic heart failure, ischemic stroke/TIA and non-coronary heart disease predicted the treatment with Walfarin. Conclusions OAC use is extremely low in Chinese patients with non-valvular atrial fibrillation. More efforts are warranted to improve OAC use in these patients.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2013年第11期931-934,共4页
Chinese Journal of Cardiology
关键词
心房颤动
抗凝药
华法林
Atrial fibrillation
Anticoagulants
Walfarin
