摘要
目的探讨应用便携单导联心电仪在养老机构中开展房颤筛查及随访的效果。方法选择在重庆市两家养老机构休养的1049例老年人,采用“好朋友”便携单导联动态心电记录仪(以下简称为单导联心电仪),对研究对象进行单导联心电图检查。结合单导联心电图检查结果及既往房颤病史,确定房颤诊断及存在房颤的患者。分析非房颤者与房颤患者的基本特征。采用CHA2DS2-VASc评分、房颤症状评分、HAS-BLED评分对房颤患者进行病情评估。随访3个月,分析抗凝药物的使用情况及其不良反应。结果1049例老年人中,诊断为非房颤者983例(86.1%);诊断为房颤患者66例(6.3%),其中首诊房颤患者25例(2.4%)、非首诊房颤患者41例(3.9%)。不同性别、年龄老年人房颤患病率的差异均无统计学意义(P均>0.05)。66例房颤患者中,共64例经CHA2DS2-VASc评分评估为栓塞风险高危,9例经HAS-BLED评分评估为出血风险高危。随访后,房颤抗凝治疗率由基线的16.7%提升至40.9%。结论应用单导联心电仪在养老机构中进行房颤筛查,老年人配合度高,筛查高效,可使老年人房颤治疗获益。
Objective To evaluate the effect of using portable single-lead electrocardiograph for atrial fibrillation screening and follow-up in nursing institutions.Methods A total of 1,049 elderly people who were living in two nursing institutions in Chongqing were selected.They used the"good friend"portable single-lead dynamic electrocardiograph(single-lead ECG)to conduct single-lead ECG examination.Their diagnosis of atrial fibrillation was confirmed by combining the results of single-lead ECG and previous history of atrial fibrillation.Non-atrial fibrillation patients’and atrial fibrillation patients’basic characteristics were analyzed.The patients with atrial fibrillation were assessed with CHA2DS2-VASc score,the atrial fibrillation symptom score and the HAS-BLED score.Follow up them for 3 months to realize the use of anticoagulants and its adverse reactions.Results Of the 1,049 elderly patients,983(86.1%)were diagnosed with nonatrial fibrillation;66 patients(6.3%)were diagnosed with atrial fibrillation,including 25 patients(2.4%)who were first diagnosed with atrial fibrillation and 41 patients(3.9%)who were not first diagnosed.There was no statistically significant differences in the prevalence of atrial fibrillation between different genders and ages(P>0.05).Of the 66 patients with atrial fibrillation,64 were assessed as having a high risk of embolism by the CHA2DS2-VASC score,and 9 were assessed as having a high risk of bleeding by the HAS-BLED score.After follow-up,the rate of anticoagulation therapy increased from 16.7%at baseline to 40.9%.Conclusion The application of single-lead ECG in the atrial fibrillation screening in nursing institutions has high degree of cooperation and high screening efficiency,which can benefit those elderly atrial fibrillation patients.
作者
丁昭鑫
杨文
杨淋
吴晓玲
谭文豪
邓辉胜
DING Zhaoxin;YANG Wen;YANG Lin;WU Xiaoling;TAN Wenhao;DENG Huisheng(Geriatrics Department,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)
出处
《老年医学研究》
2020年第2期35-39,共5页
Geriatrics Research
关键词
心房颤动
单导联心电仪
房颤筛查
养老机构
老年人
atrialfibrillation
single-leadelectrocardiograph
atrialfibrillationscreening
nursinginstitutions
aged
