摘要
目的对心律失常病房及非心律失常病房中心房颤动(房颤)患者的管理情况进行比较,以期进一步优化房颤患者的管理方案。方法收集2019年9月至2021年9月在天津医科大学第二医院心内科心律失常病房及非心律失常病房住院的1537例房颤患者资料。根据房颤患者住院时入住心律失常病房与否,分为房颤专病管理组和房颤非专病管理组。对两组患者基线情况、口服抗凝药使用情况、心率控制药物及抗心律失常药物使用情况、抗血小板药物使用情况进行比较。结果房颤非专病管理组CHA_(2)DS_(2)-VASc评分分数的平均值高于房颤专病管理组,且差异有统计学意义[(4.76±1.71)分比(3.46±1.87)分,P<0.001]。两组患者在性别、年龄、充血性心力衰竭、高血压病、糖尿病、脑卒中、血管疾病等方面比较,差异均有统计学意义(均P<0.05)。房颤非专病管理组内阵发性房颤类型及永久性房颤类型较房颤专病管理组更多(P<0.001)。房颤非专病管理组控制心室率药物使用率(56.0%比40.1%)、β受体阻滞剂使用率(50.7%比36.6%)、地高辛使用率(17.6%比5.2%)均明显高于房颤专病管理组,差异均有统计学意义(均P<0.001)。房颤专病管理组抗心律失常药物使用率(49.8%比22.6%)、胺碘酮使用率(26.2%比5.6%)、决奈达隆使用率(3.1%比0.4%)及普罗帕酮使用率(2.9%比0.1%)均明显高于房颤非专病管理组,差异均有统计学意义(均P<0.001);而索他洛尔使用率两组比较,差异无统计学意义(P=0.855)。房颤非专病管理组行冠状动脉检查的患者明显高于房颤专病管理组(43.6比25.7%,P<0.001),差异有统计学意义。结论房颤患者因接受不同专病病房的管理而在治疗方案上有一定偏差。
Objective To investigate the difference between the management of patients in arrhythmia ward and non-arrhythmia wards and optimize the management plan of patients with atrial fi brillation.Methods Data of 1537 patients with atrial fi brillation admitted to the arrhythmia ward and non-arrhythmia ward in the Department of Cardiology of the Second Hospital of Tianjin Medical University from September 2019 to September 2021 were collected.Baseline data,use of oral anticoagulants,use of heart rate control drugs and antiarrhythmic drugs,and use of antiplatelet drugs were compared between the two groups.Results The mean CHA_(2)DS_(2)-VASc score in the non-specialized atrial fibrillation(AF)management group was higher than that in the specialized AF management group,and the diff erence was statistically signifi cant[(4.76±1.71)vs.(3.46±1.87),P<0.001].There were statistically signifi cant diff erences between the two groups in terms of gender,age,comorbidities such as heart failure,hypertension,diabetes,stroke,and vascular disease(all P<0.001).The proportion of paroxysmal and permanent AF types in the non-specialized AF management group was higher(P<0.001).The usage rates of rate control drugs(56.0%vs.40.1%),beta-blockers(50.7%vs.36.6%),and digoxin(17.6%vs.5.2%)were significantly higher in the non-specialized AF management group compared to the specialized AF management group,all with statistical signifi cance(all P<0.001).The usage rates of antiarrhythmic drugs(49.8%vs.22.6%),amiodarone(26.2%vs.5.6%),dronedarone(3.1%vs.0.4%),and propafenone(2.9%vs.0.1%)were signifi cantly higher in the specialized AF management group compared to the non-specialized AF management group,all with statistical significance(all P<0.001),while there was no statistical diff erence in the usage rate of sotalol between the two groups.The proportion of patients undergoing coronary artery examination in the non-specialized AF management group(43.6%)was signifi cantly higher than that in the specialized AF management group(25.7%),with statistical
作者
杨倩
柏庚
李广平
YANG Qian;BAI Geng;LI Guang-ping(Department of Cardiology,the Second Hospital of Tianjin Medical University,Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease,Tianjin Institute of Cardiology,Tianjin 300211,China;Department of Ultrasound,Aerospace Central Hospital,Beijing 100000,China)
出处
《中国介入心脏病学杂志》
CSCD
2024年第2期76-80,共5页
Chinese Journal of Interventional Cardiology
基金
国家自然科学基金项目(82270336)
天津市卫生健康委员会科技项目(ZC20125)
天津医科大学第二医院临床医学研究项目(2019LC01)。
关键词
心房颤动
心律失常病房
非心律失常病房
心房颤动管理差异
Atrial fibrillation
Arrhythmia ward
Non-arrhythmia ward
Differences in atrial fibrillation management202402
