老年人心房颤动的临床特点及危险因素分析

H. Li
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There were 316 cases of male (45.1%) and 384 cases of female (54.9%).Age and GenderThe chosen patients were divided into three groups (65-74 years old, 75-84 years old, 85 years old and above). The number of AF was increased with age, and the largest proportion (49.9%) was 75-84 years old group. In every group, female was more than male (P>0.05).Relative CausesThe number of different causes of elderly AF: 481 cases of coronary heart disease(68.7%), 406 cases of hypertension (58.0%), 341 cases of heart failure (48.7%), 191 cases of diabetes (27.3%), 105 cases of valvular disease(15.0%), 25 cases of myocardiopathy (3.6%), 21 cases of sinus sick syndrome (3.0%), 20 cases of pulmonary heart disease(2.9%), 15 cases of lone AF (2.1%), 2 cases of congenital heart disease (0.3%). Then, 41 cases of rheumatic valvular disease, accounting for 39. 0% of the valvular disease, 5.9% of the total.Types of AFThere were 595 cases of nonvalvular AF, accounted for 85.0% of the total. The ratio of male to female was 1:1.2. In volvular AF, the ratio of male to female: was 1:1.3. In 314 cases of PAF, the ratio of male to female: was 1:1.3. In 386 cases of persistent AF, the ratio of male to female: was 1:1.1. Female was the most popular in all types (P>0.05).Clinical Data ComparisonThe age was older, the size of left atria diameter, CRP, uric acid and the incidence of heart failure, hypertension, cardiac valvular disease were higher while the LVEF was lower in PeAF group than in PAF group (P<0.05).Spearman Correlation AnalysisThere was age, heart failure, valvular disease, CRP, uric acid and left atrial diameter, which were positive correlations (P<0.05). LVEF was a negative correlation.Logistic Regression AnalysisThe risk factors for PeAF were analyzed by multivariate logistic regression analysis. 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引用次数: 0

摘要

目的:探讨老年房颤(AF)在年龄、性别、房颤类型及相关病因等方面的流行病学特点。分析老年人持续性房颤(PeAF)的危险因素,指导老年人房颤的预防和治疗。方法:收集2016年9月1日至2017年9月30日辽宁省人民医院住院的老年房颤患者资料,总结老年房颤的流行病学特征。采用Spearman相关分析和多元logistic回归分析PeAF的危险因素。结果:按照排除标准,筛选出700例老年房颤患者。平均年龄77.1±6.9岁。男性316例(45.1%),女性384例(54.9%)。年龄与性别选取的患者分为65 ~ 74岁、75 ~ 84岁、85岁及以上三组。房颤发病数量随年龄增长而增加,以75 ~ 84岁年龄组最多,占49.9%。各组女性均多于男性(P>0.05)。老年房颤不同病因:冠心病481例(68.7%)、高血压406例(58.0%)、心力衰竭341例(48.7%)、糖尿病191例(27.3%)、瓣膜病105例(15.0%)、心肌病25例(3.6%)、窦病综合征21例(3.0%)、肺心病20例(2.9%)、单纯性房颤15例(2.1%)、先天性心脏病2例(0.3%)。然后,41例风湿性心瓣膜病,占39例。占瓣膜病的0%,占总数的5.9%。房颤类型非瓣膜性房颤595例,占85.0%。男女比例为1:1.2。小叶房颤的男女比例为1:1.3。314例PAF中,男女比例为1:1.3。386例持续性房颤,男女比例为1:1.1。各类型中以女性居多(P>0.05)。PeAF组患者年龄越大,左房直径大小、CRP、尿酸、心衰、高血压、心瓣膜病发生率均高于PAF组,LVEF低于PAF组(P<0.05)。Spearman相关分析年龄、心力衰竭、瓣膜病、CRP、尿酸、左房内径呈正相关(P<0.05)。LVEF呈负相关。Logistic回归分析采用多因素Logistic回归分析PeAF的危险因素。结果表明,左心房直径和尿酸水平是老年PEAF的独立危险因素。结论:老年人房颤发病率随年龄增长而增加。以75 ~ 84岁年龄组最多。各年龄段老年女性人数均大于男性。对老年妇女房颤的关注是非常重要的,在老年人中,非瓣膜性房颤是常见的。老年人房颤的前三大病因是冠心病、高血压和心力衰竭。在老年人中,合并症是常见的,管理是一个主要的治疗目标。CRP、左心房直径是老年人PeAF的独立危险因素。
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Clinical Characteristics and Risk Factors of Atrial Fibrillation in the Elderly
Objective: To investigate the epidemiobgical characteristics of the elderly with atrial fibrillation (AF) in age, gender, the types of AF and relative causes. And To analyze the risk factors of persistent AF (PeAF), then use them to guide to prevent and treat for AF in the elderly.Methods: Collect the data of elderly patients with AF who were admitted to Liaoning People's Hospital from September 1, 2016 to September 30, 2017, and summarize the epidemiological characteristics of AF in the elderly. The risk factors for PeAF were analyzed by Spearman correlation analysis and mltivariate logistic regression analysis. Result: In accordance with the exclusion criteria,700 cases of elderly patients with AF were selected. The average age was 77.1±6.9 years old. There were 316 cases of male (45.1%) and 384 cases of female (54.9%).Age and GenderThe chosen patients were divided into three groups (65-74 years old, 75-84 years old, 85 years old and above). The number of AF was increased with age, and the largest proportion (49.9%) was 75-84 years old group. In every group, female was more than male (P>0.05).Relative CausesThe number of different causes of elderly AF: 481 cases of coronary heart disease(68.7%), 406 cases of hypertension (58.0%), 341 cases of heart failure (48.7%), 191 cases of diabetes (27.3%), 105 cases of valvular disease(15.0%), 25 cases of myocardiopathy (3.6%), 21 cases of sinus sick syndrome (3.0%), 20 cases of pulmonary heart disease(2.9%), 15 cases of lone AF (2.1%), 2 cases of congenital heart disease (0.3%). Then, 41 cases of rheumatic valvular disease, accounting for 39. 0% of the valvular disease, 5.9% of the total.Types of AFThere were 595 cases of nonvalvular AF, accounted for 85.0% of the total. The ratio of male to female was 1:1.2. In volvular AF, the ratio of male to female: was 1:1.3. In 314 cases of PAF, the ratio of male to female: was 1:1.3. In 386 cases of persistent AF, the ratio of male to female: was 1:1.1. Female was the most popular in all types (P>0.05).Clinical Data ComparisonThe age was older, the size of left atria diameter, CRP, uric acid and the incidence of heart failure, hypertension, cardiac valvular disease were higher while the LVEF was lower in PeAF group than in PAF group (P<0.05).Spearman Correlation AnalysisThere was age, heart failure, valvular disease, CRP, uric acid and left atrial diameter, which were positive correlations (P<0.05). LVEF was a negative correlation.Logistic Regression AnalysisThe risk factors for PeAF were analyzed by multivariate logistic regression analysis. It showed that left atria diameter and uric acid level were the independent risk factors of elderly PEAF.Conclusion:In the elderly, the number of AF cases increase with age. The group of 75-84 years old was the largest part. The number of older females was larger than male in all ages. It was important to pay more attention to old woman with AF.In the elderly, nonvalvular atrial fibrillation is popular. The top three causes of AF in the elderly were CHD, hypertension and heart failure. In the elderly, comorbidities were frequent, and the management was a major therapeutic objective.CRP, 1eft atria diameter were the independent risk factors for PeAF in the elderly.
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