CHC2017 :中国房颤流行病学的变迁 11年间患病率增20倍 , 房颤相关卒中增加13倍

2017-08-10 佚名 中国循环杂志

中国一项使用1千万人的医保数据库47万居民的调查结果显示, 中国房颤及其相关脑卒中负担增加显着,近11年房颤患病率增加20倍,房颤相关卒中增加13倍。

中国一项使用1千万人的医保数据库47万居民的调查结果显示, 中国房颤及其相关脑卒中负担增加显着,近11年房颤患病率增加20倍,房颤相关卒中增加13倍。

房颤及其相关脑卒中负担增加,与中国人口基数大、老龄化及老年共病的发生密切相关。估计每5个中国成年人一生中,就有1人有发生房颤的风险,略低于西方人群;75岁以上的高龄老年人群发生房颤的风险比50岁以上人群增加2倍。

与 51~60岁的人相比,71~80岁的人群中房颤患病率增加5倍,80岁以上的高龄老年房颤患病率增加了6倍。

房颤危险因素有变化

过去20年,风湿性心脏病、扩张型心肌病、心力衰竭、甲状腺功能亢进症、冠心病、慢性阻塞性肺疾病、糖尿病高血压及高龄是房颤常见的危险因素。

近15年,房颤合并风湿性心脏病和慢阻肺患者减少,而合并高血压、冠心病、动脉粥样硬化、糖尿病、非风湿性瓣膜病等疾病的房颤患者显着增加。

房颤抗凝面临挑战

过去20 年,中国房颤患者中阿司匹林使用较为普遍,口服抗凝治疗率显着低于欧美国家,社区研究报道的华法林抗凝治疗率波动在0.5%~2.7%,医院基础研究报道的抗凝治疗率为 6.6%~9.1%。

多个真实世界研究报道,华法林未能有效防治脑卒中。阜外医院杨艳敏教授团队开展的中国房颤注册研究显示,房颤患者中脑卒中年发生率为7.4%,用华法林治疗与未抗凝治疗的患者相比无差异。

近7年,中国房颤患者中阿司匹林使用率开始下降,但抗血小板药物使用率仍高于口服抗凝药物,而非抗栓药物的使用率仍达到23.5%。

进入新型口服抗凝药(NOAC)时代,口服抗凝治疗率逐渐提高。正在全国 44 家中心进行的 ChiOTEAF 研究数据显示,目前中国房颤患者平均抗凝治疗率达39%,NOAC使用比例已达到17%,接近华法林使用率。

然而,房颤抗凝管理有待优化,20%的血栓高危患者仍未接受有效的抗凝治疗。
另一方面,40%的血栓高危患者同时有出血高危风险,临床医生需重视房颤患者的出血风险管理

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=255673, encodeId=a3482556e319, content=学习学习有用的, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ef781002, createdName=topnew, createdTime=Tue Oct 24 20:53:17 CST 2017, time=2017-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250493, encodeId=659f1250493f5, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411279, encodeId=e78514112e9c0, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552134, encodeId=a53b1552134c7, content=<a href='/topic/show?id=2d194589f3' target=_blank style='color:#2F92EE;'>#CHC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4589, encryptionId=2d194589f3, topicName=CHC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0cbf14265668, createdName=mei536, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232183, encodeId=2bb82321833c, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Aug 10 14:53:53 CST 2017, time=2017-08-10, status=1, ipAttribution=)]
    2017-10-24 topnew

    学习学习有用的

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=255673, encodeId=a3482556e319, content=学习学习有用的, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ef781002, createdName=topnew, createdTime=Tue Oct 24 20:53:17 CST 2017, time=2017-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250493, encodeId=659f1250493f5, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411279, encodeId=e78514112e9c0, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552134, encodeId=a53b1552134c7, content=<a href='/topic/show?id=2d194589f3' target=_blank style='color:#2F92EE;'>#CHC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4589, encryptionId=2d194589f3, topicName=CHC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0cbf14265668, createdName=mei536, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232183, encodeId=2bb82321833c, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Aug 10 14:53:53 CST 2017, time=2017-08-10, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=255673, encodeId=a3482556e319, content=学习学习有用的, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ef781002, createdName=topnew, createdTime=Tue Oct 24 20:53:17 CST 2017, time=2017-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250493, encodeId=659f1250493f5, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411279, encodeId=e78514112e9c0, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552134, encodeId=a53b1552134c7, content=<a href='/topic/show?id=2d194589f3' target=_blank style='color:#2F92EE;'>#CHC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4589, encryptionId=2d194589f3, topicName=CHC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0cbf14265668, createdName=mei536, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232183, encodeId=2bb82321833c, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Aug 10 14:53:53 CST 2017, time=2017-08-10, status=1, ipAttribution=)]
    2017-08-12 xugumin
  4. [GetPortalCommentsPageByObjectIdResponse(id=255673, encodeId=a3482556e319, content=学习学习有用的, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ef781002, createdName=topnew, createdTime=Tue Oct 24 20:53:17 CST 2017, time=2017-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250493, encodeId=659f1250493f5, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411279, encodeId=e78514112e9c0, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552134, encodeId=a53b1552134c7, content=<a href='/topic/show?id=2d194589f3' target=_blank style='color:#2F92EE;'>#CHC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4589, encryptionId=2d194589f3, topicName=CHC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0cbf14265668, createdName=mei536, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232183, encodeId=2bb82321833c, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Aug 10 14:53:53 CST 2017, time=2017-08-10, status=1, ipAttribution=)]
    2017-08-12 mei536
  5. [GetPortalCommentsPageByObjectIdResponse(id=255673, encodeId=a3482556e319, content=学习学习有用的, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ef781002, createdName=topnew, createdTime=Tue Oct 24 20:53:17 CST 2017, time=2017-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250493, encodeId=659f1250493f5, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411279, encodeId=e78514112e9c0, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552134, encodeId=a53b1552134c7, content=<a href='/topic/show?id=2d194589f3' target=_blank style='color:#2F92EE;'>#CHC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4589, encryptionId=2d194589f3, topicName=CHC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0cbf14265668, createdName=mei536, createdTime=Sat Aug 12 04:16:00 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232183, encodeId=2bb82321833c, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Aug 10 14:53:53 CST 2017, time=2017-08-10, status=1, ipAttribution=)]
    2017-08-10 131****1460

    学习了受益匪浅。

    0

相关资讯

Stroke:房颤抗凝有没有年龄限制?

随着预期寿命增加以及健康状况的改善,弄清更高龄患者采用抗凝治疗的安全性非常重要。因此,来自瑞典?rebro大学医院的Peter Appelros等在Stroke上发表了他们的研究结果,他们分析了4个国家综合登记研究的观察性数据(从2006年到2013年)共23356例合并AF的卒中患者,年龄介于80-100岁。第二个目的是为了验乞出血风险和常用药物之间的关系。

腹痛+房颤,远没有你想的那么简单

病历简介:老年女性,69岁,主因“腹痛8小时,发现心肌酶升高3小时” 入院就诊。既往有2型糖尿病、青光眼、白内障、腰椎间盘突出、左肺腺癌切除术后、下肢静脉曲张。

Blood:接受抗凝治疗的房颤患者颅内出血风险几何?

颅内出血(ICH)是房颤(AF)患者口服抗凝治疗最令人畏惧和具有毁灭性的并发症之一,与显着的发病率和死亡率相关。2017年6月,发表在《Blood》的一项由美国、瑞典、巴西等国科学家进行的研究,考察了接受抗凝治疗的房颤患者的颅内出血风险。

JAHA:房颤可增加痴呆的发生风险!

既往研究显示房颤患者的认知功能减退和痴呆的发生风险更高,但是房颤患者发生痴呆的相关危险因素很少有研究。近日,在国际心血管权威杂志JAHA上发表了一篇旨在评估痴呆与房颤相关性的临床研究。本研究纳入了6432名ARIC‐NCS(动脉粥样硬化危险性的神经认知研究)队列中的个体作为研究对象。在2011到2013年间,参与者进行了相关的体格检查,包括超声心动图、详细的认知评估以及脑磁共振成像。痴呆、轻度的认

Eur Heart J:每周工作≥55小时房颤风险增加,与心梗时房颤风险相似

一项对85 494例受试者随访10年的欧洲研究表明,工作时间过长可能是房颤的危险因素之一。

JACC:房颤合并肾功能不全患者 非维生素K拮抗剂如何给药?

2017年6月,发表在《J Am Coll Cardiol》的一项由美国科学家进行的研究,考察了房颤合并肾功能不全患者临床常用的非维生素K拮抗剂口服抗凝药给药方案,评估了用药不足与用药过度与患者结局之间的相关性。