105例心房颤动患者的临床特征分析

张奇军　李丹　俞丽宁波市鄞州区第二医院心内科，浙江宁波　315100

105例心房颤动患者的临床特征分析

张奇军李丹俞丽
宁波市鄞州区第二医院心内科，浙江宁波315100

目的分析房颤住院患者的临床特征，探索提高抗凝治疗的方法。方法选择2015年6～10月之间所有我院心内科住院的房颤患者，对其性别、年龄、伴随疾病、华法林使用及抗血小板药物使用情况进行分析。结果我院心内科所有房颤的住院患者共105例，其中男48例（45.7%），女57例（54.3%），平均年龄（77.0±7.7）岁，平均住院天数（10.57±4.90）d。结论房颤住院患者基本为高龄老年患者，且伴有多种疾病，具有栓塞的高危风险。为了能让房颤患者得到最大程度的受益，应加强抗凝治疗。

心房颤动；抗凝；解决方案；华法林

[Abstract]Objective To ana1yze the c1inica1 feature of hospita1ized patients with atria1 fibri11ation and investigate the measures to improve the coagu1ation treatment.Methods Patients with atria1 fibri11ation who were hospita1ized in the department of cardio1ogy in our hospita1 from June to October 2015 were se1ected and the gender，age，concomitant diseases，app1ication of warfarin and the app1ication situation of antip1ate1et drug were ana1yzed.Results In the tota1 number of 105 patients with atria1 fibri11ation who were hospita1ized in the department of cardio1ogy in our hospita1，48 patients were ma1e（45.7%）and 57 patients were fema1e（54.3%）.The average age was（77.0±7.7）years o1d and the average 1ength of stay was（10.57±4.90）days.Conclusion The hospita1ized patients with atria1 fibri11ation were basica11y e1-der ones with mu1tip1e concomitant diseases，which is of high risk of embo1ism.Coagu1ation treatment shou1d be enhanced in order to benefit the patients with atria1 fibri11ation to the most.

[Key words]Atria1 fibri11ation；Coagu1ation；So1ution；Warfarin

心房颤动（以下简称房颤）是心内科的常见病、多发病，是心血管疾病中最为常见的心律失常，在老年人群中尤为常见，常导致发生脑卒中及体循环栓塞事件［1］。有研究证据表明，血栓栓塞事件风险高的房颤患者进行规范化抗凝治疗可以显著改善患者预后，但我国大多数房颤患者并未行抗凝治疗，而以抗血小板为主［2］。即使应用华法林的患者中，其国际标准化比值（INR）未监测或INR保持在无效的低水平。导致这一现状的原因是多方面的，主要原因可能是临床医生、患者及家属对于血栓栓塞性并发症危害性认识不足以及对传统抗凝药物华法林致出血风险增加过度担忧及INR监测的不方便［3］。实际上，严格遵照相关指南、正确掌握适应证、动态评估栓塞及出血风险、严密监测凝血功能，房颤患者抗凝治疗的获益远超过其风险。……