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普通男性人群中心房颤动的住院治疗:发病率及危险因素。

Hospitalizations for atrial fibrillation in the general male population: morbidity and risk factors.

作者信息

Wilhelmsen L, Rosengren A, Lappas G

机构信息

Section of Preventive Cardiology, The Cardiovascular Institute, Göteborg University, Sweden.

出版信息

J Intern Med. 2001 Nov;250(5):382-9. doi: 10.1046/j.1365-2796.2001.00902.x.

Abstract

OBJECTIVES

To analyse the incidence, prevalence, aetiology, risk factors and prognosis of hospitalizations for atrial fibrillation.

SUBJECTS

A random population sample of 7495 men aged 47-55 years was first examined in 1970-73. During follow-up until 1996 (mean 25.2 years) 754 men were hospitalized with a diagnosis of atrial fibrillation.

RESULTS

In the age groups of 55-64, 65-74 and 75-79 years, the incidence rate was 2.0, 5.8 and 17.3 per 1000 person years, and the prevalence 1.2, 4.2 and 8.0%, respectively. Definite or possible coronary heart disease was diagnosed in 46.0%, heart failure in further 20.2% and valvular heart disease or cardiomyopathy in 4.5%. In bivariate analysis adjusted for age, the following factors were significantly associated with future hospitalization for fibrillation: a family history of myocardial infarction, stroke in mother, dyspnoea at entry, alcohol abuse, high body stature and body weight, high blood pressure but not diabetes, high serum cholesterol, high heart rate, smoking, coffee consumption or psychological stress. Significant risk factors in multivariate analysis were age, odds ratio (OR) [95% confidence interval (CI)] -1.11 (1.07, 1.16) per year, hospitalization for coronary heart disease or heart failure -6.77 (5.17, 8.87), stroke in mother - 1.49 (1.15, 1.93), high body stature -1.04 (1.03, 1.06) per cm, high body mass index (BMI) -1.07 (1.04, 1.10) per kg m(-2), as well as hypertension -1.33 (1.07, 1.65). After a diagnosis of atrial fibrillation, mortality was increased by 3.3 times.

CONCLUSION

In spite of a clinical association with coronary heart disease, risk factors for atrial fibrillation were only partly the same. Prevention includes avoidance of weight gain and control of blood pressure as well as prevention of myocardial infarction and heart failure.

摘要

目的

分析心房颤动住院治疗的发病率、患病率、病因、危险因素及预后。

对象

1970 - 1973年首次对7495名年龄在47 - 55岁的男性进行随机抽样调查。在随访至1996年(平均25.2年)期间,有754名男性因心房颤动诊断而住院。

结果

在55 - 64岁、65 - 74岁和75 - 79岁年龄组中,发病率分别为每1000人年2.0、5.8和17.3例,患病率分别为1.2%、4.2%和8.0%。确诊或可能患有冠心病的占46.0%,患有心力衰竭的占20.2%,患有心脏瓣膜病或心肌病的占4.5%。在对年龄进行校正的双变量分析中,以下因素与未来因心房颤动住院显著相关:心肌梗死家族史、母亲患中风、入院时呼吸困难、酗酒、身材高大和体重、高血压而非糖尿病、高血清胆固醇、高心率、吸烟、喝咖啡或心理压力。多变量分析中的显著危险因素为年龄,比值比(OR)[95%置信区间(CI)]为每年 - 1.11(1.07,1.16),因冠心病或心力衰竭住院 - 6.77(5.17,8.87),母亲患中风 - 1.49(1.15,1.93),身高每厘米 - 1.04(1.03,1.06),体重指数(BMI)每千克米(-2) - 1.07(1.04,1.10),以及高血压 - 1.33(1.07,1.65)。心房颤动诊断后,死亡率增加3.3倍。

结论

尽管心房颤动与冠心病存在临床关联,但其危险因素仅部分相同。预防措施包括避免体重增加、控制血压以及预防心肌梗死和心力衰竭。

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