摘要
目的通过分析海南省中医院心房颤动(房颤)中心住院患者临床特征分布规律以指导临床诊疗工作.方法采用回顾性调查方法,收集中国房颤中心数据填报平台海南省中医院2020年10月至2022年9月填报的住院患者的临床诊疗资料(包括住院信息、诊断与治疗、症状、健康评估、查体、检查、检验、治疗药物)、欧洲心律学会(EHRA)症状评分、卒中危险分层管理CHA2DS2-VASc评分、出血风险评估HAS-BLED评分.设定分析的各项检查指标正常参考值为心率60~100次/min,QTc间期男性<480 ms、女性<470 ms,B超检查射血分数(EF)0.50~0.75,左心房前后径<35 mm,左室舒张期末内径(LVEDD)男性<55 mm、女性<50 mm,无左心房血栓,国际标准化比值(INR)0.85~1.20,脑钠肽(BNP)0~100 ng/L,N末端脑钠肽前体(NT-proBNP)心内科0~125 ng/L、非心内科0~250 ng/L.结果共收集667例患者的诊疗信息,其中瓣膜性房颤39例,非瓣膜性房颤628例.各项诊断(查体/检查/检验)指标完成率为19.94%~100.00%.不同EHRA分级症状评分、HAS-BLED评分、体质量指数(BMI)、高血压、心率、EF、左心房前后径、LVEDD、左心房血栓、INR(华法林使用者)、BNP、NT-proBNP、房颤治疗方法患者比例比较差异均有统计学意义(均P<0.01),不同性别CHA2DS2-VASc评分、不同性别QTc、不同NT-proBNP患者比例比较差异均无统计学意义(均P>0.05).使用抗心律失常药物治疗409例,治疗率为61.32%,心率为<60、60~100和>100次/min患者使用药物治疗比例比较差异有统计学意义[46.51%(20/43)、54.60%(196/359)、72.83%(193/265),P<0.01],用药率以β受体阻滞剂最高,不同抗心律失常药物使用率比较差异有统计学意义(P<0.01).抗凝治疗342例,治疗率51.27%,瓣膜性房颤治疗率明显高于非瓣膜性房颤[84.62%(33/39)比49.20%(309/628)],差异有统计学意义(P<0.01).非瓣膜性房颤患者CHA2DS2-VASc评分男性≥2分和女性≥3分患者与男性<2分和女性<3分患者治疗率
Objective To analyze the population distribution pattern of inpatients in the China Atrial Fibrillation Center of Hainan Traditional Chinese Medicine Hospital to guide clinical diagnosis and treatment.Methods Clinical diagnosis and treatment(including hospitalization information,diagnosis and treatment,symptoms,health assessment,physical examination,examination,testing,therapeutic drugs),European Heart Rhythm Association(EHRA)symptom score,CHA2DS2-VASc score for predicting stroke risk stratification in atrial fibrillation,HAS-BLED score for predicting bleeding risk in anticoagulated were collected from Hainan Traditional Chinese Medicine Hospital from October 2020 to September 2022 in the data flling platform of China Atrial Fibrillation Center through retrospective investigation.The normal reference values of various examination indicators set for analysis are heart rate 60-100 beats/min,QTc interval<480 ms for males and<470 ms for females,ejection fraction(EF)0.50-0.75 for B-ultrasound,left atrial anteroposterior diameter<35 mm,left ventricular end-diastolic diameter(LVEDD)<55 mm for males and<50 mm for females,no left atrial thrombosis,international normalized ratio(INR)0.85-1.20,brain natriuretic peptide(BNP)0-100 ng/L,N-terminal pro-brain natriuretic peptide(NT-proBNP)0-125 ng/L in cardiology,0-250 ng/L in non cardiology.Results Among 667 patients,there were 39 cases of valvular atrial fibrillation and 628 cases of non valvular atrial fibrillation.The completion rate of various diagnostic(physical examination/examination/testing)indicators was 19.94%-100.00%.Statistically significant differences were showed in every EHRA symptom score,HAS-BLED score,BMI,hypertension,heart rate,EF,left atrial diameter,LVEDD,left atrial thrombus,INR(Warfarin user),BNP,NT-proBNP and atrial fibrllation treatment methods(all P<O.01).No statistically significant difference was shown in CHA2DS2-VASc scores for each gender,QTc and NT-proBNP(all P>0.05).409 patients were treated with antiarrhythmic drugs,with a treatment rate of 61.3
作者
李品慧
黄正新
及孟
Li Pinhui;Huang Zhengxin;Ji Meng(Department of Cardiovascular Medicine,Hainan Provincial Hospital of Traditional Chinese Medicine,Haikou 570200,Hainan,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2023年第6期706-712,共7页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
海南省卫生计生行业科研项目(20A200506)。
关键词
中国房颤中心
住院患者
临床特征
China Atrial Fibrillation Center
Hospitalized population
Clinical features
