2025 年第 9 期 第 20 卷

老年心房颤动患者社区抗凝治疗出血风险与风险感知的差异分析

Difference analysis of bleeding risk and risk perception in elderly patients with atrial fibrillation receiving anticoagulant therapy in community

作者：石小怡李艳艳饶晶晶黎丽黄俊

英文作者：Shi Xiaoyi Li Yanyan Rao Jingjing Li Li Huang Jun

单位：南方医科大学附属广东省人民医院（广东省医学科学院）广东省老年医学研究所综合三区，广州510080

英文单位：Third Comprehensive Ward Guangdong Provincial People′s Hospital Affiliated to Southern Medical University(Guangdong Academy of Medical Sciences) Guangdong Institute of Geriatrics Guangzhou 510080 China

关键词：心房颤动；出血风险；风险感知；抗凝治疗

英文关键词：Atrialfibrillation;Bleedingrisk;Riskperception;Anticoagulanttherapy

• 摘要：

• 目的 调查老年心房颤动患者社区抗凝治疗过程中的出血风险与风险感知的差异现状，为精准预防患者的出血提供参考。方法 选取2018年6月至2023年7月于广东省人民医院接受诊治指导的487例老年心房颤动患者作为研究对象，调查其入组时的出血风险评分以及疾病风险感知水平，通过多元线性回归方法分析老年心房颤动患者社区抗凝治疗出血风险与疾病风险感知水平的影响因素。结果 多元线性回归分析结果显示，年龄、心房颤动病因以及用药情况是老年心房颤动患者社区抗凝治疗出血风险的独立影响因素（标准化回归系数分别为0558、0.140、0.096，均P<0.05），年龄、家庭人均月收入、用药情况、共病高血压以及共病高血糖是老年心房颤动患者社区抗凝治疗疾病风险感知水平的独立影响因素（标准化回归系数分别为0.341、-0.482、0.064、0.059、0.100，均P<0.05）。结论 老年心房颤动患者社区抗凝治疗过程中的出血风险较高，同时存在疾病风险感知偏差问题，且受年龄、用药情况以及共患疾病的影响，造成患者的出血风险增加以及疾病风险感知能力降低。

• Objective To investigate the current situation of differences in bleeding risk and risk perception in elderly patients with atrial fibrillation during anticoagulant therapy in the community, so as to provide reference for precise prevention of bleeding in patients. Methods A total of 487 elderly patients with atrial fibrillation who were accepted diagnosis and treatment guidance in Guangdong Provincial People′s Hospital from June 2018 to July 2023 were selected as the research objects. The bleeding risk score and disease risk perception level at enrollment were investigated. Multiple linear regression method was used to analyze the influencing factors of bleeding risk and disease risk perception in elderly patients with atrial fibrillation receiving anticoagulant therapy in the community. Results Multivariate linear regression analysis showed that age, etiology of atrial fibrillation and medication were independent influencing factors for bleeding risk of community anticoagulant therapy in elderly patients with atrial fibrillation (standardized regression coefficients were 0.558, 0.140, and 0.096, respectively, all P<0.05). Age, family per capita monthly income, medication, comorbidity of hypertension and comorbidity of hyperglycemia were independent influencing factors of disease risk perception of community anticoagulation therapy in elderly patients with atrial fibrillation (standardized regression coefficients were 0.341, -0.482, 0.064, 0.059, and 0.100, respectively, all P<0.05). Conclusion Elderly patients with atrial fibrillation have a high risk of bleeding during anticoagulant therapy in the community, and there is a bias in disease risk perception. The patients are affected by age, medication and comorbidities, which increase the risk of bleeding and reduce the ability of disease risk perception.