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目的:调查分析某市军队干休所高龄老年人心房颤动(房颤)的发病及抗栓治疗情况,为采取相关防治措施提供依据。方法:对选择某市16所军队干休所≥80岁老年人388例,采用查阅历年体检资料及健康档案、向本人或家属和及干休所医师咨询等方法,调查了解房颤的发生、发展及治疗情况。结果:本组388例中,确诊房颤61例,占15.7%。在80~84岁、85~89岁、90岁以上3个年龄段,房颤发生率分别为10.3%、16.3%和21.4%。在房颤61例中,常见基础病分别是冠心病42例(68.9%)、高血压病40例(65.6%),高血压合并冠心病35例(57.4%)等。在房颤61例中,服用阿司匹林或氯吡格雷48例(78.7%),服用华法林13例(21.3%),服用华法林者比例非常显著低于服用阿司匹林或氯吡格雷者(P<0.01)。服用阿司匹林或氯吡格雷者中,发生栓塞事件6例(12.5%);服用华法林者发生栓塞事件1例(7.7%);两者比较,差异显著(P<0.05)。结论:军队干休所高龄老年人房颤发生率低于国内文献报道,冠心病、高血压病是高龄老年人房颤发生的主要基础病,抗栓治疗服用阿司匹林或氯吡格雷较多,应采取相应措施加强基础病及房颤的防治。
Objective: To investigate the incidence and antithrombotic therapy of atrial fibrillation (AF) in elderly people in a certain army in the city for the purpose of providing evidences for taking relevant prevention and treatment measures. Methods: A total of 388 elderly patients aged 80 or older who were selected for military intervention in 16 military units in a certain city were surveyed to find out about the occurrence of atrial fibrillation by referring to the medical records and health records over the years, consulting with themselves or their relatives and physicians in their work, Development and treatment. Results: 388 cases in this group, 61 cases of atrial fibrillation diagnosed, accounting for 15.7%. The incidence of atrial fibrillation was 10.3%, 16.3% and 21.4% at age of 80 to 84 years, 85 to 89 years and 90 years old respectively. In 61 cases of atrial fibrillation, common underlying diseases were coronary heart disease in 42 cases (68.9%), hypertension in 40 cases (65.6%), hypertension with coronary heart disease in 35 cases (57.4%) and so on. Among the 61 patients with atrial fibrillation, 48 (78.7%) were taking aspirin or clopidogrel, 13 (21.3%) were taking warfarin, and those taking warfarin were significantly lower than those taking aspirin or clopidogrel (P <0.01). Among the patients taking aspirin or clopidogrel, embolism occurred in 6 cases (12.5%); embolization occurred in 1 case (7.7%) in warfarin; the difference was significant (P <0.05). Conclusion: The prevalence of atrial fibrillation in elderly elders in the army dry-off age is lower than that reported in the domestic literature. Coronary heart disease and hypertension are the main underlying diseases in elderly patients with atrial fibrillation. Aspirin or clopidogrel should be used in antithrombotic therapy more frequently. Take appropriate measures to strengthen the prevention and treatment of basic diseases and atrial fibrillation.