| Objective1The purpose of the research was to analyze the epidemiological characteristics of the AF patients in age distribution, causes and associated factors, the type of AF and tate of stroke.2The feature of non valvular AF were studied and risk factors of stroke were estimated in order to provide data for clinical treatment.methodsSingle-center retrospective analysis was used to analyzed the patient date whom were admitted to the cardio department in The Second Hospital of Tianjin Medical University from 2000 to 2009, Basic clinical features, discharge diagnosis, echocardiography and laboratory date were clearly collected. The patients were divided into different groups depending on ages, sex, cardiac function, high blood pressure, and pulse pressrre in order to analyze the clinical features of AF. Meanwhile, Logistic regresson was used to analyze the indepent risk factors of AF and stoke.Result1 The total of 2011 cases with AF were enrolled.Mean age was 65.5 years old,rang 20 to 104 years. The number of AF progressively rose with age. There are 1001 female cases and 1011 male cases respectively,and had no statistical differentce. (χ2=12.308,P>0.05)2 The causes and associated conditions of AF:advanced age was 65.6%, heart failure was 53.4% hypertension was 49.1%, coronary heart disease was 45.7%.rheumatic valvular disease was 17.4% in 2000 year, and depressed to 7.8% ten years later.3 There were 276 valvular disease,1689 nonvalvular and 46 lone AF.The age of nonvalvular AF was older than that of valvular AF (59.6±10.7vs69.8±11.7,t=-11.6,p<0.05).Among the valvular AF,female occupied the larger part.(χ2=68.859,p<0.05).The left atria diameter of patients with valvular AF was larger than that of nonvalvular AF(t=20.632, p<0.05).but there was no significant different in the ejection fraction between the two typs.4 There was no significant different in the risk factors such as advanced age, heart failure, hypertension, coronary heart disease between man and women. The proportion of suffering rheumatic valvular disease was 20.9% in women,which was higher than men 6.4% (x2=67.823,p<0.05),and in contrast, the patients with the lone AF,in male was higher than in female (3.1%vs1.2%,x2=24.589,p<0.05).5 The left atria diameter was increased(p<0.05) and the ejection fraction was decreased as the cardiac function classification increased.6 The number of AF patients in blood pressure degree 2was 47.2%,that was higher than that digree 1,21.6%,(x2=21.570, p<0.05).With the increasing of puls pressure,the cases of persistent AF increased.7The proportion of paroxysmal and persistent AF was 39.1% and 60.9% respectively. The age of persistent AF was older than the former one (67.2±12.3vs69.3±11.8,t=-3.438,p=0.000).The proportion of hypertention,and sick sinus syndrome on paroxysmal AF was significantly higher than that of persistent AF,but the proportion of coronary heart disease,heart failure,cardiomyopathy and age on the persistent AF was higher than that of paroxymal AF.However it make no statistical difference on diabetes.In addition,patients with the persistent AF had a higher level of systolic blood pressure and puls pressure than the paroxymal AF.8The values of left atrial diameter(LAD),left ventricular end diastolic diameter (LVDD),right ventricular(RV) and left ventricular ejection fraction (LVEF) were (39.7±8.0)mm, (48.6±7.5)mm,(19.5±5.0)mm and (55.7±10.3)% respectively in patients with paroxysmal AF,and were (49.4±12.0)mm, (51.3±10.0)mm, (22.2±7.1)mm and (51.3±11.6)% respectively in patients with persistent AF, the differences in LAD,LVDD,RV and LVEF between the two group were significantly different (P<0.05).The proportion of persistent AF increased with the left atria diameter getting larger.9Compared with the paroxysmal AF,the UA level of the patients with persistent AF significantly increased (401.2±143.6vs350.0±120,P=0.000),but the total cholesterol was decreased (4.7±1.2vs4.4±1.1,t=-9.297,p=0.000)10 It was shown by Binary Logistic regression analysis that age(OR4.45,P=0.000), Left atria diameter (OR1.135,P=0.000) and uric acid levels(OR1,220,P=0.028).were the independent risk factors of AF. 11 Among all the patients with stroke,the proportion patients with female,heart failure aging,cornary heart disease,hypertension,diabetes ana left atria thrombus were higher than that patients without brain stroke,in addition,there was higher level of left atria dimeter and serum total cholesterol. Binary Logistic regression analysis showed that left atria thrombus(OR=3.789,P=0.004),heart failure (OR=3.044,P=0.000) and serum total cholesterol (OR=1.234,P=0.020)were the independent risk factors of stroke in patients with AFConclusion1 The clinical features of age, etiology, types of AF, stroke which were considered as risk factors to AF patients were almost the same as the references.2. Systolic blood pressure ang puls pressure may be the risk factor for the endurance of AF.3 Age,Left atria diameter and uric acid levels.were the independent risk factors of AF. 4 Left atria thrombus,heart failure and serum total cholesterol were the independent risk factors of stroke in patients with AF. |
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