中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2013年
11期
931-934
,共4页
高鹏%方全%王佳丽%范静波%朱孔博%杨德彦%邓华%程康安
高鵬%方全%王佳麗%範靜波%硃孔博%楊德彥%鄧華%程康安
고붕%방전%왕가려%범정파%주공박%양덕언%산화%정강안
心房颤动%抗凝药%华法林
心房顫動%抗凝藥%華法林
심방전동%항응약%화법림
Atrial fibrillation%Anticoagulants%Walfarin
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.
目的 評估我國非瓣膜病心房顫動(房顫)患者口服華法林抗凝(oral walfarin anticoagulation,OAC)治療不足的狀況併對其影響因素進行分析.方法 本研究為單中心註冊研究,入選我院就診的非瓣膜病房顫患者併登記其一般情況、疾病特徵、閤併疾患及抗凝治療等,對患者進行CHA2DS2-VASc風險評分,評估我國房顫患者的抗凝狀況併對華法林使用的影響原因進行單因素及多因素分析.結果 全部入選的576例非瓣膜病房顫人群中,有214例(39.4％) OAC治療,在476例藥物治療(非導管消融)的房顫患者中,144例(30.3％)例使用華法林抗凝.持續性房顫、糖尿病史、慢性心力衰竭史、缺血性卒中/一過性腦缺血髮作史、CHA2DS2-VASc評分高者更多使用OAC治療,閤併冠心病的房顫患者由于更多用抗小闆藥物而較少OAC治療.在多因素迴歸分析中,持續性房顫、慢性心衰史、缺血性卒中/一過性腦缺血髮作史及非冠心病是使用OAC治療的預測因子.結論 我國非瓣膜病房顫患者中使用華法林抗凝治療嚴重不足,且未能嚴格遵循血栓栓塞風險評估進行抗凝.
목적 평고아국비판막병심방전동(방전)환자구복화법림항응(oral walfarin anticoagulation,OAC)치료불족적상황병대기영향인소진행분석.방법 본연구위단중심주책연구,입선아원취진적비판막병방전환자병등기기일반정황、질병특정、합병질환급항응치료등,대환자진행CHA2DS2-VASc풍험평분,평고아국방전환자적항응상황병대화법림사용적영향원인진행단인소급다인소분석.결과 전부입선적576례비판막병방전인군중,유214례(39.4％) OAC치료,재476례약물치료(비도관소융)적방전환자중,144례(30.3％)례사용화법림항응.지속성방전、당뇨병사、만성심력쇠갈사、결혈성졸중/일과성뇌결혈발작사、CHA2DS2-VASc평분고자경다사용OAC치료,합병관심병적방전환자유우경다용항소판약물이교소OAC치료.재다인소회귀분석중,지속성방전、만성심쇠사、결혈성졸중/일과성뇌결혈발작사급비관심병시사용OAC치료적예측인자.결론 아국비판막병방전환자중사용화법림항응치료엄중불족,차미능엄격준순혈전전새풍험평고진행항응.
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 multivariable regression analysis.Results OAC therapy with Walfarin was applied on Only 214 (39.4％) out of 576 consecutive patients with nonvalvular 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 CHA2DS2-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.
