2021 年第 1 期 第 16 卷

单中心非瓣膜性心房颤动患者抗凝治疗现状分析

Current status and analysis of anticoagulant therapy in patients with nonvalvular atrial fibrillation in single center

作者：唐薇1陆世杰2郑铁3张红丽1单鸿波1李瑞杰1姜红岩1

英文作者：Tang Wei1 Lu Shijie2 Zheng Tie3 Zhang Hongli1 Shan Hongbo1 Li Ruijie1 Jiang Hongyan1

单位：1北京市第一中西医结合医院心内科100026；2北京市心肺血管疾病研究所100029；3首都医科大学附属北京安贞医院心外科100029

英文单位：1Department of Cardiology Beijing First Hospital of Integrated Traditional Chinese and Western Medicine Beijing 100026 China; 2Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China; 3Department of Cardiac Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：非瓣膜性心房颤动；抗凝治疗；单中心

英文关键词：Nonvalvularatrialfibrillation;Anticoagulanttherapy;Singlecenter

• 摘要：

• 目的 调查单中心非瓣膜性心房颤动（NVAF）患者抗凝治疗现状，分析影响口服抗凝治疗的可能原因。方法通过住院信息系统选取2017年1月至2019年12月在北京市第一中西医结合医院心内科住院的NVAF患者351例，对其一般资料和口服抗凝治疗情况等进行回顾性分析。结果 351例NVAF患者中126例（35.9%）接受口服抗凝药物治疗（抗凝治疗组），225例（64.1%）未接受口服抗凝药物治疗（未抗凝治疗组）。抗凝治疗组年龄明显低于未抗凝治疗组［（76±9）岁比（79±10）岁］，持续性/永久性心房颤动比例明显高于未抗凝治疗组［64.3%(81/126)比48.4%(109/225)］，差异均有统计学意义（均P＜0.05）。未抗凝治疗患者中157例（69.8%）因不能配合华法林监测或新型口服抗凝药费用问题而拒绝抗凝治疗，57例（25.3%）因合并血液系统或消化系统疾病而未予抗凝治疗。结论 NVAF患者口服抗凝治疗率偏低，其原因与北京市第一中西医结合医院患者年龄较高、合并出血性疾病以及不能配合监测有关。

• Objective To investigate present situation of anticoagulant therapy in patients with nonvalvular atrial fibrillation (NVAF) from single center, and analyze probable causes that influence oral anticoagulant therapy. Methods Totally 351 NVAF patients admitted to department of Cardiology of Beijing First  Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to December 2019 were retrospectively selected by inpatient information system. The general information and oral anticoagulant treatment were analyzed. Results Among the 351 NVAF patients, 126 cases (35.9%) received oral anticoagulant therapy (anticoagulant treatment group), and 225 cases (64.1%) did not receive oral anticoagulant therapy (non-anticoagulant treatment group). The age of anticoagulant treatment group was significantly lower than that of non-anticoagulant treatment group［（76±9）years vs （79±10）years］, and the proportion of persistent/permanent atrial fibrillation of anticoagulant treatment group was significantly higher than that of non anticoagulant treatment group［64.3%(81/126) vs 48.4%(109/225)］(both P＜0.05). Among the patients without anticoagulant treatment, 157 cases (69.8%) refused anticoagulant treatment because they could not cooperate with monitoring warfarin therapy or could not afford the cost of new oral anticoagulant drugs, and 57 cases (25.3%) did not receive anticoagulant treatment because of the complication of hematological or digestive system diseases. Conclusions   The rate of oral anticoagulation therapy in NVAF patients is low. The reasons include that the patients in Beijing first Hospital of Intergrated Traditional Chinese and Western Medicine are older, have bleeding disorders and cannot cooperate with monitoring.