中国心房颤动的患病率及风险：一项全国性横断面流行病学研究。
Prevalence and risk of atrial fibrillation in China: A national cross-sectional epidemiological study.
作者信息
Shi Shaobo, Tang Yanhong, Zhao Qingyan, Yan Hong, Yu Bin, Zheng Qiangsun, Li Yigang, Zheng Liangrong, Yuan Yiqiang, Zhong Jingquan, Xu Jian, Wu Yanqing, Xu Jing, Chen Lin, Li Shufeng, Jiang Jian, Wang Jingfeng, Fan Jie, Chen Minglong, Tang Baopeng, Li Wei, Wu Qiang, Shi Bei, Zhou Shenghua, Zhao Xingsheng, Yin Yuehui, Zhang Zheng, Zhong Guoqiang, Han Xuebin, Liu Fan, Wu Ming, Gao Lianjun, Yang Bo, Huang He, Huang Congxin
机构信息
Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan 430060, Hubei, China.
Cardiovascular Research Institute, Wuhan University, Wuhan 430060, China.
出版信息
Lancet Reg Health West Pac. 2022 Apr 11;23:100439. doi: 10.1016/j.lanwpc.2022.100439. eCollection 2022 Jun.
BACKGROUND
Atrial fibrillation (AF) is the most common persistent cardiac arrhythmia. This study aimed to estimate its prevalence and explore associated factors in adults aged 18 years or older in China.
METHODS
Study data were derived from a national sample from July 2020 to September 2021. Participants were recruited using a multistage stratified sampling method from twenty-two provinces, autonomous regions, and municipalities in China. AF was determined based on a history of diagnosed AF or electrocardiogram results.
FINDINGS
A total of 114,039 respondents were included in the final analysis with a mean age of 55 years (standard deviation 17), 52·1% of whom were women. The crude prevalence of AF was 2·3% (95% confidence interval [CI] 1·7-2·8) and increased with age. The age-standardized AF prevalence was 1·6% (95% CI 1·6-1·7%) overall, and 1·7% (1·6-1·8%), 1·4% (1·3-1·5%), 1·6% (95% CI 1·5-1·7%), and 1·7% (1·6-1·9%) in men, women, urban areas, and rural areas, respectively. The prevalence was higher in the central regions (2·5%, 2·3-2·7%) than in the western regions (1·5%, 1·0-2·0%) and eastern regions (1·1%, 1·0-1·2%) in the overall population, either in the gender or residency subgroups. The associated factors for AF included age (per 10 years; odds ratio 1·41 [95% CI 1·38-1·46]; < 0·001), men (1·34 [1·24-1·45]; < 0·001), hypertension (1·22 [1·12-1·33]; < 0·001), coronary heart disease (1·44 [1·28-1·62]; < 0·001), chronic heart failure (3·70 [3·22-4·26]; < 0·001), valvular heart disease (2·13 [1·72-2·63]; < 0·001), and transient ischaemic attack/stroke (1·22 [1·04-1·43]; = 0·013).
INTERPRETATION
The prevalence of AF was 1.6% in the Chinese adult population and increased with age, with significant geographic variation. Older age, male sex, and cardiovascular disease were potent factors associated with AF. It is crucial to increase the awareness of AF and disseminate standardized treatment in clinical settings to reduce the disease burden.
FUNDING
This research was supported the Nature Science Foundation of Hubei province (No: 2017CFB204).
背景
心房颤动（AF）是最常见的持续性心律失常。本研究旨在评估中国18岁及以上成年人中AF的患病率，并探讨相关因素。
方法
研究数据来源于2020年7月至2021年9月的全国样本。采用多阶段分层抽样方法从中国22个省、自治区和直辖市招募参与者。根据AF诊断史或心电图结果确定AF。
结果
共有114,039名受访者纳入最终分析，平均年龄55岁（标准差17），其中52.1%为女性。AF的粗患病率为2.3%（95%置信区间[CI]1.7 - 2.8），且随年龄增加而升高。总体年龄标准化AF患病率为1.6%（95%CI 1.6 - 1.7%），男性、女性、城市地区和农村地区分别为1.7%（1.6 - 1.8%）、1.4%（1.3 - 1.5%）、1.6%（95%CI 1.5 - 1.7%）和1.7%（1.6 - 1.9%）。在总体人群中，以及按性别或居住地分层的亚组中，中部地区的患病率（2.5%，2.3 - 2.7%）高于西部地区（1.5%，1.0 - 2.0%）和东部地区（1.1%，1.0 - 1.2%）。AF的相关因素包括年龄（每10岁；比值比1.41[95%CI 1.38 - 1.46]；P < 0.001）、男性（1.34[1.24 - 1.45]；P < 0.001）、高血压（1.22[D1.12 - 1.33]；P < 0.001）、冠心病（1.44[1.28 - 1.62]；P < 0.001）、慢性心力衰竭（3.70[3.22 - 4.26]；P < 0.001）、心脏瓣膜病（2.13[1.72 - 2.63]；P < 0.001）以及短暂性脑缺血发作/中风（1.22[1.04 - 1.43]；P = 0.013）。
解读
中国成年人群中AF患病率为1.6%，且随年龄增加而升高，存在显著的地域差异。年龄较大、男性以及心血管疾病是与AF相关的重要因素。提高对AF的认识并在临床环境中推广标准化治疗以减轻疾病负担至关重要。
资助
本研究得到湖北省自然科学基金（编号：2017CFB204）的支持。
Zotero 插件