心律失常病房与非心律失常病房在心房颤动管理中的差异比较研究A comparative research of the difference between arrhythmia and non-arrhythmia wards in the management of atrial fibrillation
杨倩,柏庚,李广平
摘要(Abstract)：
目的 对心律失常病房及非心律失常病房中心房颤动（房颤）患者的管理情况进行比较，以期进一步优化房颤患者的管理方案。方法 收集2019年9月至2021年9月在天津医科大学第二医院心内科心律失常病房及非心律失常病房住院的1 537例房颤患者资料。根据房颤患者住院时入住心律失常病房与否，分为房颤专病管理组和房颤非专病管理组。对两组患者基线情况、口服抗凝药使用情况、心率控制药物及抗心律失常药物使用情况、抗血小板药物使用情况进行比较。结果房颤非专病管理组CHA2DS2-VASc评分分数的平均值高于房颤专病管理组，且差异有统计学意义[（4.76±1.71）分比（3.46±1.87）分，P<0.001]。两组患者在性别、年龄、充血性心力衰竭、高血压病、糖尿病、脑卒中、血管疾病等方面比较，差异均有统计学意义（均P<0.05）。房颤非专病管理组内阵发性房颤类型及永久性房颤类型较房颤专病管理组更多（P<0.001）。房颤非专病管理组控制心室率药物使用率（56.0%比40.1%）、β受体阻滞剂使用率（50.7%比36.6%）、地高辛使用率（17.6%比5.2%）均明显高于房颤专病管理组，差异均有统计学意义（均P<0.001）。房颤专病管理组抗心律失常药物使用率（49.8%比22.6%）、胺碘酮使用率（26.2%比5.6%）、决奈达隆使用率（3.1%比0.4%）及普罗帕酮使用率（2.9%比0.1%）均明显高于房颤非专病管理组，差异均有统计学意义（均P<0.001）；而索他洛尔使用率两组比较，差异无统计学意义（P=0.855）。房颤非专病管理组行冠状动脉检查的患者明显高于房颤专病管理组（43.6比25.7%,P<0.001），差异有统计学意义。结论 房颤患者因接受不同专病病房的管理而在治疗方案上有一定偏差。
关键词(KeyWords)： 心房颤动;心律失常病房;非心律失常病房;心房颤动管理差异
基金项目(Foundation): 国家自然科学基金项目（82270336）;; 天津市卫生健康委员会科技项目（ZC20125）;; 天津医科大学第二医院临床医学研究项目（2019LC01）
作者(Author): 杨倩,柏庚,李广平
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