Investigation On Incidence And Treatment Of Atrial Fibrillation In 2004 And

Objective:(1)By analyzing the clinical data of patients with atrial fibrillation in 2014 and 2004, to understand the general information of patients with atrial fibrillation, Such as age, sex, duration and classification of atrial fibrillation, disease spectrum and so on;(2)Though analysis of clinical events and treatment program in patients with atrial fibrillation, to observe the changes of antithrombotic therapy and other treatment options in patients with atrial fibrillation in our hospital during ten years;(3)According to the traditional Chinese medicine syndromes and combination forms of two groups of patients with atrial fibrillation,,to explore the characteristics of TCM symptoms of atrial fibrillation. It provides reference and basis for the prevention and treatment of atrial fibrillation in future clinical work.Methods:The subjects of this study were the patients with atrial fibrillation who treated at Department of Cardiology of Dongzhimen hospital from January 1,2014 to December 31, 2014 and January 1,2004 to December 31,2004,all selected patients with atrial fibrillation (AF) has complete clinical data and related auxiliary examination items, repeatedly hospitalized patients with first diagnosis of AF hospitalization data, more than the times of hospitalization is not counted in, a total of 214 cases of. All the cases were collected from the medical records management system of Dongzhimen Hospital of Beijing University of Chinese Medicine, according to the inclusion criteria and exclusion criteria for screening of all cases, the eligible cases were included in this study. Complete clinical data were collected, including general situation, relevant past medical history and comorbidities, bad habits, the information of TCM four diagnostic methods and objective indexes. Collate data, data entry Excel, and then use the SPSS 21 statistical software to analyze the data.Results:1.This study included 214 cases of atrial fibrillation, male and female ratio is about 1.62:1, In 2014, a total of 161 cases,2004 total number of 53 cases. General situation comparison:There was no difference in gender and age between the two groups of patients with atrial fibrillation; But it is seen in the age stratification of atrial fibrillation, The two groups of patients were 70-79 years of age accounted for the largest proportion, followed by 80-89 years old; No difference in the duration of atrial fibrillation and typing, in two groups of patients were in chronic atrial fibrillation accounted for the largest proportion, in the classification of chronic atrial fibrillation, persistent atrial fibrillation is the most common; There was a positive correlation between the duration of atrial fibrillation and the grading of cardiac function;2.The blood lipids, blood glucose, body mass index and cardiac ultrasound were different in the two groups of patients with atrial fibrillation;3.There was no significant difference between the two groups of patients with atrial fibrillation in the common cause of atrial fibrillation, which is most common in patients with pulmonary heart disease and rheumatic heart disease, followed by hyperthyroidism; In the common disease of atrial fibrillation, there were differences between the two groups of patients with hyperlipidemia, there were no differences in the other comorbid diseases;4.In clinical events in patients with atrial fibrillation in two groups, the incidence of thrombotic events and bleeding events was higher in 2004 than in 2014, cerebral embolism is the most common in the event of thromboembolism, the most common clinical bleeding events were gastrointestinal bleeding;5.The CHA2DS2-VASC scores of the two groups were all higher, and the proportion of high risk population was the largest; And the occurrence of cerebral embolism in patients with atrial fibrillation are high risk groups:the higher the CHA2DS2-VASC score, the greater the risk of stroke in patients with atrial fibrillation;6.Compared with 2004, the use of low molecular weight heparin and Hua Falin and clopidogrel increased in 2014, but aspirin use rate decreased; Compared with the guidelines for atrial fibrillation, in 2014, the use of Hua Falin, the intensity of anticoagulation and INR compliance rates are low;7.In 2014, in the single drug therapy of atrial fibrillation, aspirin and Hua Falin were given priority to, followed by clopidogrel; In the combined application of the two drugs, the combination of low molecular weight heparin and Hua Falin, followed by aspirin and Grey, low molecular weight heparin and aspirin, Hua Falin and aspirin, etc; In the combined application of the three drugs, the combination of low molecular weight heparin and aspirin plus clopidogrel is the most common in clinical practice, followed by low molecular weight heparin+Hua Falin+aspirin or clopidogrel;In 2004, aspirin alone in monotherapy,, only three cases of patients with low molecular weight heparin and 1 case with warfarin, but in the use process combined with aspirin;8. In the treatment of traditional Chinese medicine, two groups of patients are in the application of Chinese medicine injection and decoction of Chinese medicine widely, and in 2014 the proportion rise significantly;9.In other options for the treatment of atrial fibrillation (AF), the two groups of patients were to control ventricular rate and drug complex firms accounted for the proportion of maximum, beta blockers, digoxin and amiodarone were the main drugs in the selection of drugs; In the treatment of radiofrequency ablation, the proportion of 2014 was significantly higher than that in 2004;10.TCM Syndromes of two groups of patients with atrial fibrillation were the most common syndrome of qi deficiency and blood stasis syndrome and phlegm turbidity syndrome; In TCM syndrome combination, The proportion of the two card and three card combination is higher;11.in 2014,Atrial fibrillation patients with coronary heart disease were more common with Qi deficiency syndrome and blood stasis syndrome; Atrial fibrillation patients with heart failure were more common with Syndrome of Blood stasis and syndrome of retention of fluid in the body. Atrial fibrillation patients with diabetes were more common with Syndrome of retention of fluid in the body.in 2004,Atrial fibrillation patients with hypertension or cerebrovascular disease were more common with Syndrome of Turbid phlegm.Conclusion:1.2004 years,2014 years of comparison, the disease spectrum of patients with atrial fibrillation in our hospital there was no significant difference; two of patients with atrial fibrillation CHA2DS2-VASC score of the population is mainly concentrated in the 3-5;2.Compared with 2004, the year 2014 anticoagulant use ratio is greatly increased, but at present, there are still some problems is:with atrial fibrillation guideline recommended compared to our hospital anticoagulation to symptoms of atrial fibrillation in patients with warfarin use rate is still low, and lower use of warfarin in patients with atrial fibrillation INR. Most patients did not reach the target range and anticoagulation intensity far from enough, failed to play to the effect of effective prevention of thromboembolism; antithrombotic therapy in traditional Chinese medicine, traditional Chinese medicine clinical use are different, ranging from the injection, tablet to decoction, is still in the exploratory stage, the lack of standardized guidelines or consensus.3.There was no significant difference between the two years in the treatment of arrhythmia;4.The year 2014,2004 in our hospital of atrial fibrillation in patients with TCM syndrome were with Qi deficiency and blood stasis syndrome, phlegm syndrome is most common, also is the main pathogenesis of atrial fibrillation patients; combinations of symptoms form is mainly constituted by the both ends of the actual deficiency mixed mainly; Therefore, the clinical should pay attention to yi Qi, promoting blood circulation and resolving phlegm therapy.