摘要
背景心房颤动(简称房颤)是临床上较为常见的心律失常,具有高患病率、高致残率、高治疗费的特点,严重影响患者生活质量,国内不同地区以及不同人群中的房颤患病率有很大差异,目前新疆生产建设兵团地区对于房颤的患病率无较大规模流行病学调查。目的了解新疆生产建设兵团石河子地区房颤的患病率、相关的危因素、规范化的治疗状况,为本地区房颤预防、管理、治疗提供可靠数据支持。方法采用横断面年龄比例1∶10分层随机抽样调查2021年5月—2023年6月新疆生产建设兵团石河子地区18个农牧团场及市区18岁及以上常住居民63079人。采用问卷收集患者基线资料、房颤流行病学、知晓率及治疗情况。将患者分为房颤组(n=737)与非房颤组(n=62342)。采用多因素Logistic回归分析探究房颤发生的影响因素。结果共纳入新疆生产建设兵团第八师石河子地区居民63079人,平均年龄(54.9±15.3)岁。筛查出房颤患者737人,患病率为1.17%,根据年龄校正后患病率为1.12%。筛查人群中房颤知晓率仅为1.62%(1021/63079),其中确诊房颤人群中房颤知晓率52.78%(389/737)。18~39岁、40~49岁、50~59岁、60~69岁、70~79岁、≥80岁房颤患病率分别为0.05%(5/9964)、0.32%(29/9076)、0.62%(135/21686)、1.28%(151/11810)、3.05%(207/6776)、5.57%(210/3767);男性和女性房颤患病率分别为1.60%(441/27591)、0.83%(296/35488);汉族、回族、维吾尔族、哈萨克族、其他民族房颤患病率分别为1.20%(720/60014)、0.70%(7/1007)、0.62%(7/1130)、1.67%(2/120)、1.41%(1/171);城市区域及农牧团场区域房颤患病率分别为0.79%(350/44504)、2.08%(387/18575)。房颤组与非房颤组年龄、性别、年龄段分布、居住区域、受教育程度比较,差异有统计学意义(P<0.05)。房颤组吸烟、饮酒、高血压、冠心病、2型糖尿病、高脂血症、慢性心力衰竭、脑血管疾病、心脏瓣膜病、慢性肺部疾病、睡眠呼吸暂停综合征、甲状腺功能异常、外周血管疾病、肿瘤比例高于非房颤组(P<0.05)。多因素Logistic回归分析结果显示,年龄、性别、饮酒、高血压、心脏瓣膜病、慢性心力衰竭、甲状腺功能异常、睡眠呼吸暂停综合征、肿瘤为房颤发生的影响因素(P<0.05)。新发现房颤85例(11.53%)、阵发性房颤257例(34.87%)、持续性房颤178例(21.16%)、永久性房颤217例(29.44%);口服抗凝药物360例、行房颤射频消融术或一站式治疗23例,本地区房颤治疗率51.96%。房颤患者中规范化治疗、未规范化治疗和未治疗分别为360例(48.85%)、21例(2.85%)、356例(48.30%),新发现房颤、阵发性房颤、持续性房颤、永久性房颤的规划化治疗率分别为11.11%、28.89%、24.72%、35.28%,不同类型房颤规划化治疗率比较,差异有统计学意义(χ^(2)=18.918,P=0.004)。结论新疆生产建设兵团石河子地区房颤患病率基本持平于全国水平,危险因素与国内外研究相近,但人群中房颤知晓率、及房颤规范化治疗率明显偏低,情况不容乐观。
Background Atrial fibrillation(AF)is a common clinical arrhythmia characterized by high prevalence,high disability rate,and high treatment costs,severely affecting patients' quality of life.Currently,there is no large-scale epidemiological survey on the prevalence of AF in the Xinjiang Corps region.Objective To further understand the prevalence,associated risk factors,and standardized treatment status of AF in the Shihezi area of the Xinjiang Corps,this study aims to provide reliable data support for the prevention,management,and treatment of AF in this region.Methods A cross-sectional age-stratified random sampling survey was conducted from May 2021 to June 2023 among 63 079 permanent residents aged 18years and above in 18 pastoral and agricultural groups and urban areas of the Shihezi area of the Xinjiang Corps.A questionnaire was used to collect baseline data,epidemiological information,awareness,and treatment status of AF.Patients were divided into an AF group(n=737)and a non-AF group(n=62 342).Multifactorial Logistic regression analysis was used to explore the influencing factors of AF occurrence.Results A total of 63 079 residents from the Shihezi area of the Eighth Division of the Xinjiang Corps were included,with an average age of(54.9±15.3) years.A total of 737 AF patients were identified,with a prevalence rate of 1.17%,and an age-adjusted prevalence rate of 1.12%.The awareness rate of AF in the screened population was only 1.62%(1 021/63 079),of which the awareness rate among diagnosed AF patients was 52.78%(389/737).The prevalence rates of AF in the 18-39,40-49,50-59,60-69,70-79,and ≥ 80 years age groups were 0.05%(5/9 964),0.32%(29/9 076),0.62%(135/21 686),1.28%(151/11 810),3.05%(207/6 776),and 5.57%(210/3 767),respectively.The prevalence rates of AF in males and females were 1.60%(441/27 591)and 0.83%(296/35 488),respectively.The prevalence rates of AF among Han,Hui,Uyghur,Kazakh,and other ethnic groups were 1.20%(720/60 014),0.70%(7/1 007),0.62%(7/1 130),1.67%(2/120),and 1.41%(1/171),respectively.The prevalence rates of AF in urban and pastoral and agricultural areas were 0.79%(350/44 504)and 2.08%(387/18 575),respectively.There were statistically significant differences in age,gender,age group distribution,residential area,and education level between the AF and non-AF groups(P<0.05).The prevalence of smoking,alcohol consumption,hypertension,coronary heart disease,type 2 diabetes,hyperlipidemia,chronic heart failure,cerebrovascular diseases,valvular heart disease,chronic pulmonary disease,sleep apnea syndrome,thyroid dysfunction,peripheral vascular disease,and tumors was higher in the AF group than in the non-AF group(P<0.05).Multifactorial Logistic regression analysis showed that age,gender,alcohol consumption,hypertension,valvular heart disease,chronic heart failure,thyroid dysfunction,sleep apnea syndrome,and tumors were influencing factors for the occurrence of AF(P<0.05).There were 85 newly diagnosed cases of AF(11.53%),257 paroxysmal AF cases(34.87%),178 persistent AF cases(21.16%),and 217 permanent AF cases(29.44%);360cases received oral anticoagulant therapy,and 23 cases underwent radiofrequency ablation or one-stop treatment for AF,with a treatment rate of 51.96% in this region.Among AF patients,the rates of standardized treatment,non-standardized treatment,and no treatment were 360 cases(48.85%),21 cases(2.85%),and 356 cases(48.30%),respectively.The standardized treatment rates for newly diagnosed AF,paroxysmal AF,persistent AF,and permanent AF were 11.11%,28.89%,24.72%,and 35.28%,respectively.There was a statistically significant difference in the standardized treatment rates among different types of AF(χ^(2)=18.918,P=0.004).Conclusion The prevalence rate of atrial fibrillation in Shihezi area of Xinjiang Corps is basically the same as that of the whole country,and the risk factors are similar to domestic and foreign studies.However,the awareness rate of atrial fibrillation and the standardized treatment rate of atrial fibrillation in the population are obviously low,and the situation is not optimistic.
作者
张强
唐闽
邝雅杰
刘丹
赵雪燕
赵媛媛
张琳
奴尔巴合提
ZHANG Qiang;TANG Min;GUANG Yajie;LIU Dan;ZHAO Xueyan;ZHAO Yuanyuan;ZHANG Lin;NUERBAHETI(Department of Cardiology,Shihezi People's Hospital of the 8th Division of Xinjiang Corps,Shihezi 832000,China;Chinese Academy of Medical Sciences/Beijing Fuwai Hospital,Beijing 100000,China;Ecg Network Diagnosis Center,Shihezi People's Hospital of the 8th Division of Xinjiang Corps,Shihezi 832000,China)
出处
《中国全科医学》
CAS
北大核心
2024年第33期4162-4167,共6页
Chinese General Practice
基金
新疆兵团财政科技计划项目(2020CB012)
第八师石河子市科技计划项目(2022NY05,2022SF009)。
关键词
心房颤动
流行病学研究
患病率
石河子地区
横断面研究
Atrial fibrillation
Epidemiologic studies
Prevalence
Shihezi area
Cross-sectional study
