心房颤动的临床和电生理研究
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摘要
目的：探讨我国心房颤动(房颤)患者的临床特点、病因构成及变化趋势、血栓栓塞并发症的发生情况，以期为房颤及其并发症的防治提供依据。方法：收集1984-1999年门诊和住院房颤患者的连续病例资料，登记患者的流行病学特征、临床特点及并发症的发生情况，观察房颤的人群分布、病因构成及临床转归。结果：共入选房颤患者989例，其中男595例，女394例，男性所占比例显著高于女性(P＜0.01)；患者平均年龄55.1±14.7岁，瓣膜性房颤仍是我国房颤患者的主要组成部分，占50.7％，其中57.9％的患者年龄在50岁以下，高龄与低龄人群相比，瓣膜性房颤所占比例逐渐降低，非瓣膜性房颤所占比例逐渐升高。房颤患者血栓栓塞事件的发生率为14.4％，其中瓣膜性房颤的栓塞率为13.2％，非瓣膜性房颤患者的栓塞率为15.6％。结论：我国房颤患者的发病年龄低，其中半数以上是瓣膜性房颤，血栓栓塞事件的发生率高，对房颤及其并发症的预防亟待加强。
Objectives: To establish a data on the epidemiological and clinical features of atrial fibrillation, as well as the rate of thromboembolism and it's associated risk factors in China, with the purpose of providing basis for the management of atrial fibrillation and it's complications. Methods: Consecutive patients with atrial fibrillation who visited our hospital between 1984 and 1999 were enrolled, the epidemiological and clinical features of the patients ,as well as the occurrence of ischemic events were examined and recorded. Results: The study population comprise 989 atrial fibrillation patients, among whom 595 were male, making a significant greater proportion. The mean age of atrial fibrillation patients was 55.1?4.7 years. Valvular heart disease account for 50.7% of all atrial fibrillation, remained the commonest reason for atrial fibrillation in China, 57,9% of whom was younger than 50 years. The prevalence of nonvalvular atrial fibrillation was age related. The thromboembolism events is 14.4% in China, with 13.2% in valvular fibrillation and 15.6% in non-valvular fibrillation. Conclusion: The atrial fibrillation population was about a decade younger than the developed countries, more than half of them are valvular fibrillation with high embolic
complications. The prophylaxis of atrial fibrillation and it's complications should be highlighted in the clinical practise.
Objectives: To establish a data on the epidemiological and clinical features of atrial fibrillation, as well as the rate of thromboembolism and it's associated risk factors in China, with the purpose of providing basis for the management of atrial fibrillation and it's complications. Methods: Consecutive patients with atrial fibrillation who visited our hospital between 1984 and 1999 were enrolled, the epidemiological and clinical features of the patients ,as well as the occurrence of ischemic events were examined and recorded. Results: The study population comprise 989 atrial fibrillation patients, among whom 595 were male, making a significant greater proportion. The mean age of atrial fibrillation patients was 55.1?4.7 years. Valvular heart disease account for 50.7% of all atrial fibrillation, remained the commonest reason for atrial fibrillation in China, 57,9% of whom was younger than 50 years. The prevalence of nonvalvular atrial fibrillation was age related. The thromboembolism events is 14.4% in China, with 13.2% in valvular fibrillation and 15.6% in non-valvular fibrillation. Conclusion: The atrial fibrillation population was about a decade younger than the developed countries, more than half of them are valvular fibrillation with high embolic
complications. The prophylaxis of atrial fibrillation and it's complications should be highlighted in the clinical practise.
引文
1.Tomita F, Kohya T, sakurai M, et al. Prevalence and clinical characteristics of patients with atrial fibrillation Analysis of 20000cases in Japan Jpn Circ J 2000;64:653-658
2.Kannel WB, Wolf PA, Benjamin EJ, et al.Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998;82:2N-9N
3.Levy S, Maarek M, Coumel P, et al. Characterization of different subsets of atrial fibrillation in general practice in france The ALFA study.Circulation 1999;99:3028-3035
4.Petersen P.Thromboembolic complications in atrial fibrillation.Stroke 1990;21:4-13
5．马长生，周玉杰，马煜，等 中国人非瓣膜性心房颤动患者脑卒中发生率及影响因素的回顾性前瞻研究(摘要) 中国循环杂志 1999；14(增刊)：110
6．马长生，杜昕，王士雯 心房颤动与脑卒中 中国心脏起搏与心电生理杂志，2001；15：75-79
7.Kannel WB, Abbott RD, Savage DD, et al. Epidemiologic features of chronic atrial fibrillation:The Framingham Study. N Engl J Med 1982;306:1018-22
8.Miyasaka Y, Tsuji H, Tokunaga S, et al. Mild mitral regurgitation was associated with increased prevalence of thromboembolic events in patients with nonrheumati atrial fibrillation. Int J Caridiol 2000; 72:229-33
9．李立明主编 流行病学 第四版 北京：人民卫生出版社 1999：43-49
2.Kannel WB, Wolf PA, Benjamin EJ, et al.Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998;82:2N-9N
3.Levy S, Maarek M, Coumel P, et al. Characterization of different subsets of atrial fibrillation in general practice in france The ALFA study.Circulation 1999;99:3028-3035
4.Petersen P.Thromboembolic complications in atrial fibrillation.Stroke 1990;21:4-13
5．马长生，周玉杰，马煜，等 中国人非瓣膜性心房颤动患者脑卒中发生率及影响因素的回顾性前瞻研究(摘要) 中国循环杂志 1999；14(增刊)：110
6．马长生，杜昕，王士雯 心房颤动与脑卒中 中国心脏起搏与心电生理杂志，2001；15：75-79
7.Kannel WB, Abbott RD, Savage DD, et al. Epidemiologic features of chronic atrial fibrillation:The Framingham Study. N Engl J Med 1982;306:1018-22
8.Miyasaka Y, Tsuji H, Tokunaga S, et al. Mild mitral regurgitation was associated with increased prevalence of thromboembolic events in patients with nonrheumati atrial fibrillation. Int J Caridiol 2000; 72:229-33
9．李立明主编 流行病学 第四版 北京：人民卫生出版社 1999：43-49