摘要
目的了解中国老年二尖瓣反流(MR)合并心房颤动(房颤)的发生率、治疗现状,分析房颤是否与MR治疗决策及预后相关。方法选择中度以上老年MR患者2248例,分为房颤组(537例)和非房颤组(1711例),比较2组基线特点、治疗方式及预后差异。结果老年MR合并房颤发生率为23.89%。与非房颤组比较,房颤组年龄更大(P<0.01),吸烟、合并心肌病、缺血性脑卒中、心功能不全、NYHAⅢ级和Ⅳ级比例更高(72.25%vs 67.97%,14.71%vs 10.29%,12.66%vs 7.95%,73.00%vs 67.62%,40.04%vs 32.14%,17.13%vs 13.85%,P<0.05,P<0.01)。房颤组风湿性及功能性MR比例、接受二尖瓣修复比例明显高于非房颤组(P<0.01),接受干预治疗比例、住院天数、监护病房天数、院内不良事件及死亡率与非房颤组比较,无统计学差异(P>0.05)。房颤组随访12个月累积生存率、因心力衰竭再住院率与非房颤组比较,无统计学差异(P>0.05)。结论老年MR合并房颤比例较高。但房颤并未明显影响MR治疗的决策和近中期预后。
Objective To investigate the incidence and treatment of AF in elderly patients with mitral regurgitation(MR)in China,and to analyze whether AF is related to MR treatment strategy and prognosis.Methods A total of 2248≥60 years old Chinese MR patients were divided into AF group(n=537)and AF-free group(n=1711).Their baseline clinical characteristics,treatment methods and outcome were compared.Results The incidence of MR with AF was 23.89%.The age was significantly older(P<0.01),the rate of smoking was significantly higher,the incidence of cardiomypathy,ischemic cerebral stroke,cardiac insufficiency,NYHAⅢandⅣwas significantly higher in AF group than in AF-free group(72.25%vs 67.97%,14.71%vs 10.29%,12.66%vs 7.95%,73.00%vs 67.62%,40.04%vs 32.14%,17.13%vs 13.85%,P<0.05,P<0.01).The rate of rheumatic MR,functional MR and mitral repair was significantly higher in AF group than in AF-free group(P<0.01).No significant difference was detected in intervention rate,hospital stay time,ICU stay time,in-hopital adverse events,mortality and in 12-month cumulative survival rate and readmission rate due to heart failure between the two groups during the follow-up period(P>0.05).Conclusion The incidence of MR with AF is relatively high in elderly Chinese patients.The presence of AF does not affect the treatment strategy for MR and its short-and mid-term outcome in elderly Chinese MR patients.
作者
叶蕴青
周政
李喆
王墨扬
张而立
刘庆荣
齐喜玲
许海燕
吴永健
Ye Yunqing;Zhou Zheng;Li Zhe;Wang Moyang;Zhang Erli;Liu Qingrong;Qi Xiling;Xu Haiyan;Wu Yongjian(Center for Coronary Heart Disease,Peking Union Medical College,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences,Beijing 100037,China)
出处
《中华老年心脑血管病杂志》
北大核心
2021年第6期585-588,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家科技支撑计划课题(2015BAI12B02)
中国医学科学院医学与健康科技工程(2017-12M-3-002)。
关键词
心房颤动
二尖瓣闭锁不全
二尖瓣成形术
预后
atrial fibrillation
mitral valve insufficiency
mitral valve annuloplasty
prognosis
