| 王进华,王其虎,黄春燕,等.单中心老年非瓣膜性心房颤动病人抗栓现况分析[J].安徽医药,2025,29(7):1368-1371. |
| 单中心老年非瓣膜性心房颤动病人抗栓现况分析 |
| Status quo of antithrombotic therapy in elderly patients with nonvalvular atrial fibrillation at a single center |
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| DOI：10.3969/j.issn.1009-6469.2025.07.020 |
| 中文关键词: 心房颤动 抗凝药 老年人 抗栓治疗 奉贤东部 现况研究 |
| 英文关键词: Atrial fibrillation Anticoagulants Elderly Antithrombotic therapy Eastern Fengxian Prevalence study |
| 基金项目:奉贤区区科委课题(奉科 20201426) |
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| 中文摘要: |
| 目的了解上海奉贤东部老年非瓣膜性心房颤动( NVAF)病人抗栓治疗现况。方法选取 2020年 7月至 2023年 6月上海市奉贤区奉城医院住院及门诊确诊老年 NVAF病人中符合纳入及排除标准者进行面对面询问，收集基本资料，临床资料，抗栓治疗方案，进行血栓栓塞风险及出血风险评分，运用 logistic回归分析探讨可能影响抗栓治疗方案选择的因素。结果入选 600例，分析发现未抗栓治疗者 47例( 7.83%)，抗血小板治疗者 372例( 62.00%)抗凝治疗者 181例( 30.17%)。行血栓栓共塞风险评分(CHA2DS2 -VASc评分)及出血风险评分(HAS-BLED评分)有抗凝指征者总体，抗凝率 30.64%，其中男性(30.04%)女性( 31.03%)相当( P>0.05)而出血风险高危且有抗凝指征者抗凝治疗率，男性( 38.46%)高于女性( 24.03%)(P<0.05)。抗凝治疗者中，新型口服抗凝药物(，NOAC)者为 118例( 65.19%)，华法林治疗者为 63例( 34.81%)。 logistic回归分析表明高龄( OR=1.78)，吸烟史( OR=2.10)，脑卒中史( OR=2.05)高血压史(OR=2.05)首诊医师为高年资主治及以上医师( OR=2.20)为研究对象抗凝治疗方案的影响因素。结论区老年 NVAF病人治疗率仍低， NOAC应用率与指南推荐存在差距，积极奉贤东部地，抗凝，控制影响因素，高年资医师参与指导治疗，依据指南及时调整抗栓治疗方案可能有助于提高抗凝治疗率。 |
| 英文摘要: |
| Objective To know about the status quo of antithrombotic therapy in elderly patients with nonvalvular atrial fibrillation(NVAF) in Eastern Fengxian District of Shanghai.Methods The inpatients and outpatients diagnosed with NVAF in Fengcheng Hospi-tal, Fengxian District, Shanghai from July 2020 to June 2023, who met the inclusion and exclusion criteria of the study, were inter-viewed face-to-face. Basic data, clinical data and anti-thrombotic therapy were collected, and thromboembolic and bleeding risk scoringwere performed. Logistic regression analysis was made to explore the factors that may affect the selection of antithrombotic therapy.Re. sults A total of 600 patients were enrolled. The analysis results showed that 47 (7.83%) patients received no antithrombotic therapy,372 (62.00%) patients received antiplatelet therapy, and 181 (30.17%) patients received anticoagulant therapy. CHA2DS2 -VASc and HAS-BLED scoring were performed. The overall anticoagulation rate of patients with anticoagulation indications was 30.64%, with com-parable rates among males (30.04%) and females (31.03%) (P>0.05). Among patients with high bleeding risk and anticoagulation indi-cations, the anticoagulation rate in men (38.46%) was higher than that in women (24.03%) (P<0.05). Among the anticoagulated pa-tients, 118 (65.19%) cases were treated with new oral anticoagulants (NOAC) and 63 (34.81%) cases were treated with warfarin. Logis-tic regression analysis results showed that advanced age (OR=1.78), history of smoking (OR=2.10), history of stroke (OR=2.05), history of hypertension (OR=2.05), and senior attending physician (OR=2.20) were the influencing factors for anticoagulant therapy.Conclu. sion The anticoagulation rate of elderly NVAF patients in Eastern Fengxian District of Shanghai is still low, and there is a gap be-tween the NOAC application rate and the guideline-recommended NOAC use. Active control of influencing factors, participation of se-nior attending physicians in guiding treatment, and timely adjustment of anti-thrombotic therapy according to the guideline may help improve the anticoagulation rate. |
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