60例老年心房颤动患者资料的临床分析.docVIP

60例老年心房颤动患者资料的临床分析 　　作者：李娟,李曙平,谭昌金,张慧勤　　作者单位：广州军区武汉总医院老年病一科，湖北 武汉 430070 　　【摘要】目的探讨老年心房颤动(简称房颤)的病因及临床特点。方法：对我院老年病房2003年1月～2007年6月期间住院的60例男性房颤患者的临床资料进行回顾性分析。结果：患者中阵发性房颤、持续性和永久性房颤分别占12%、22%、66%;冠心病、高血压和糖尿病是引起房颤的主要病因(发病率分别占65%、52%、47%);持续性/永久性房颤心功能明显差于阵发性房颤心功能(P0.01);其左房内径显著大于阵发性房颤患者的左房内径，而射血分数显著低于阵发性房颤的射血分数(P均0.01);慢性房颤患者均合并有不同类型的其它心律失常(如病窦综合征，房室传导阻滞等);60例老年房颤患者均用过抗凝剂，仅有5例患者使用过华法林，24例患者发生脑栓塞，2例患者发生下肢或上肢动脉栓塞。结论：冠心病、高血压和糖尿病是引起房颤的主要病因;随着房颤的发展，左房内径增大、心功能逐渐恶化、左室射血分数降低;房颤常合并其它形式的心律失常;脑栓塞发生较高，应加强防治。 　　【关键词】 心房颤动,老年人,心室功能 　　Abstract：Objective:To investigate the pathogeny and clinical features of elderly patients with atrial fibrillation.Methods:A total of 60 elderly patients with atrial fibrillation were retrospectively analyzed.Results:The incidence of paroxysmal, persistent and perpetual atrial fibrillation patients were 12%,22%,66% respectively.There were 65% patients suffering from coronary heart disease, 52% hypertension and 47% diabetes mellitus.The heart function of patients with persistent or perpetual atrial fibrillation was worse than that of patients with paroxysmal atrial fibrillation (P0.01),and the internal diameter of left atrium of patients with persistent or perpetual atrial fibrillation was larger than that of paroxysmal atrial fibrillation patients, and the left ventricular ejection fraction of persistent and perpetual atrial fibrillation patients was lower than that of paroxysmal atrial fibrillation patients(P0.01).All the 60 cases of elderly patients had taken anticoagulants, but of which only 5 cases received warfarin.There were 24 cases encountered cerebral embolism and two cases encountered upper or lower limbs artery embolism.Conclusion:Coronary heart disease, hypertension and diabetes mellitus are the mainly diseases of atrial fibrillation.With atrial fibrillation developing, patients heart function decrease;There is a high incidence of cerebral embolism,must emphasis its prevention and cure. 　　Key words：Atrial fibrillation;The aged;