3 984例非瓣膜性心房颤动住院患者抗凝药物的使用情况及影响因素分析

向静; 王娜; 肖培林; 秦芳; 钱妍

doi:10.16016/j.1000-5404.202012114

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3 984例非瓣膜性心房颤动住院患者抗凝药物的使用情况及影响因素分析

临床医学 | 更新时间：2026-01-09

- 3 984例非瓣膜性心房颤动住院患者抗凝药物的使用情况及影响因素分析
- Usage of oral anticoagulant and influencing factors in nonvalvular atrial fibrillation: an analysis of 3 984 inpatients
- 第三军医大学学报 2021年43卷第12期页码：1167-1172
- 作者机构：
  
  1.400010 重庆，重庆医科大学附属第二医院: 药学部
  2.400010 重庆，重庆医科大学附属第二医院: 心血管内科
- 作者简介：
  
  [钱妍，E-mail: 552590989@qq.com QIAN Yan, E-mail: 552590989@qq.com
- 基金信息：
  
  重庆市社会事业与民生保障科技创新专项(cstc2017shmsA130041)
- DOI：10.16016/j.1000-5404.202012114
  中图分类号： R452;R541.75;R969.3
- 收稿：2020-12-19，
  
  修回：2021-03-07，
  
  纸质出版：2021-06-30
- 稿件说明：
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向静, 王娜, 肖培林, 等. 3 984例非瓣膜性心房颤动住院患者抗凝药物的使用情况及影响因素分析[J]. 第三军医大学学报, 2021,43(12):1167-1172.

Jing XIANG, Na WANG, Peilin XIAO, et al. Usage of oral anticoagulant and influencing factors in nonvalvular atrial fibrillation: an analysis of 3 984 inpatients[J]. Journal of Third Military Medical University, 2021, 43(12): 1167-1172.
向静, 王娜, 肖培林, 等. 3 984例非瓣膜性心房颤动住院患者抗凝药物的使用情况及影响因素分析[J]. 第三军医大学学报, 2021,43(12):1167-1172. DOI： 10.16016/j.1000-5404.202012114.

Jing XIANG, Na WANG, Peilin XIAO, et al. Usage of oral anticoagulant and influencing factors in nonvalvular atrial fibrillation: an analysis of 3 984 inpatients[J]. Journal of Third Military Medical University, 2021, 43(12): 1167-1172. DOI： 10.16016/j.1000-5404.202012114.

摘要

目的

了解非瓣膜性心房颤动(nonvalvular atrial fibrillation

NVAF)住院患者抗凝药物使用情况，探讨影响NVAF患者抗凝药物治疗率的相关因素。

方法

回顾性分析2016年1月1日至2019年12月31日重庆医科大学附属第二医院心内科NVAF住院患者的临床特征及口服抗凝药物使用状况。根据卒中风险分层筛选出CHA

-VASc评分≥2分的患者，了解其抗凝药物使用状况，并运用Logistic回归分析讨论抗凝治疗的影响因素。

结果

本研究纳入3 984例患者，抗凝患者为2 438例(61.2%)，2016-2019年抗凝患者分别为247例(39%)、316例(42.6%)、736例(65.3%)、1 139例(76.9%)。CHA

-VASc≥2分的患者为3418例，抗凝患者为2065例(60.4%)。Logistic回归分析显示: 年龄≥75岁(

=0.494)、血管疾病(

=0.838)、急性冠脉综合征(ACS)(

=0.583)、经皮冠状动脉介入治疗(PCI)术后(

=0.651)、出血史(

=0.436)、肾功能不全(

=0.625)、药物(

=0.634)、NOAC降价前(

=0.22)为降低抗凝治疗率的影响因素(

0.05)；房颤消融术(

=2.093)、卒中史(

=1.351)为提升抗凝治疗率的影响因素(

0.05)。

结论

NVAF患者抗凝治疗率呈逐年增长趋势，但仍低于欧美国家。出血史、合并使用抗血小板药物、肾功能不全、NOAC降价前、年龄≥75岁、合并血管疾病、ACS、PCI术后为降低抗凝治疗率的影响因素，房颤消融术、卒中史为提升抗凝治疗率的影响因素。

Abstract

Objective

To investigate the use of anticoagulant drugs in hospitalized patients with nonvalvular atrial fibrillation (NVAF)

and to explore the relevant factors that affect the efficacy of drug treatment in the patients.

Methods

A retrospective analysis was conducted on the NVAF inpatients admitted in our department from January 1

2016 to December 31

2019. Their clinical characteristics and usage of oral anticoagulants were collected and analyzed. According to the stratification of stroke risk

the patients with CHA2DS2-VASc score≥2 were selected to explore their use of anticoagulants. Logistic regression analysis was used to analyze the influencing factors of anticoagulation therapy.

Results

Among the 3 984 patients included

there were 2 438 (61.2%) anticoagulant patients

including 247 (39.0%)

316 (42.6%)

736 (65.3%)

and 1 139 (76.9%) patients

respectively during the year of 2016 to 2019. The number of patients with CHA2DS2-VASc≥2 was 3 418

and 60.4% (2 065) of them took anticoagulants. Logistic regression analysis showed that age≥75 years (

=0.494)

vascular diseases (

=0.838)

acute coronary syndrome (ACS) (

=0.583)

history of percutaneous coronary intervention (PCI) (

=0.651)

bleeding history (

=0.436)

renal insufficiency (

=0.625)

drugs (

=0.634)

and before price reduction of new oral anticoagulants (NOAC) (

=0.22) were influencing factors to reduce the rate

of anticoagulation treatment (

0.05); While

atrial fibrillation ablation (

=2.093) and stroke history (

=1.351) were influencing factors to increase the treatment rate (

0.05).

Conclusion

Though the rate of anticoagulation treatment for NVAF patients is increasing year by year

but it is still lower than that in the European and American countries. Bleeding history

combined use of antiplatelet drugs

renal insufficiency

before NOAC price reduction

age ≥75 years

accompanied with vascular diseases

ACS

and post-PCI are influencing factors to reduce the rate

and atrial fibrillation ablation and stroke history are factors increasing the rate of anticoagulant treatment.

关键词

Keywords

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