Europace：一项关于房颤的流行病学及发病率的研究

房颤是临床最常见的心律失常之一，其导致的脑卒中及其他血栓栓塞事件是患者死亡或致残的主要原因，多国的临床研究表明房颤的总发病率约为1%，近年来房颤的发病率正逐渐增加，然而目前多数临床研究都选择了特定的人群，如老年人、住院患者，仅有少数研究是针对全人群的，而特定年龄、性别的房颤的流行病学研究几乎没有。

同样关于特定性别、年龄的房颤发病率的研究也很少，目前仅有4项临床研究，其研究的年限分别为1990年至1993年、1993年至2007年、2001年至2003年和1993年至2005年，目前还没有近5年的发病率研究，据此Wilke T等通过对德国830万人群的调查研究，对房颤的流行病学及发病率情况进行了深入研究。

该研究定义的房颤患者为1年内至少2次门诊诊断为房颤或至少1次住院检查为房颤的患者，该研究的年限为2007年1月至2008年12月。首发房颤定义为在2008年新出现的房颤，并符合下列条件：第一、2007年或以前并未诊断房颤；第二、患者在2007年未服用口服抗凝药；第三、患者在2008年至少2次门诊诊断房颤或1次住院诊断房颤。结果显示，在8298000人中，有176981例房颤患者，总发病率为2.132%，房颤患者的平均年龄为73.1岁，其中55.5%为男性，70-70岁人群的发病率为7.610%，大于80岁人群房颤的发病率超过了12%。男性房颤的年发病率为4.358例/1000人，女性房颤的年发病率为3.868例/1000人。

通过该项研究可得出以下结论：本研究的结果提示房颤的总发病率及年发病率均高于以往的研究数据，特别是对于年龄大于70岁的人群。该项研究认为对于高度发达的国家，如德国，房颤的发病率正逐年上升，未来将有更多的房颤患者需要得到治疗。

doi: 10.1093/europace/eus333
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Incidence and prevalence of atrial fibrillation: an analysis based on 8.3 million patients

Thomas Wilke1,*, Antje Groth1, Sabrina Mueller1, Matthias Pfannkuche2,Frank Verheyen3, Roland Linder3, Ulf Maywald4, Rupert Bauersachs5 andGünter Breithardt6

Aims Based on an analysis of claims-based data of 8.298 million members of two German statutory health insurance funds, the aim of this contribution is to quantify age-/gender-specific prevalence/incidenceof atrial fibrillation (AF) in a German setting.Methods and results Patients were classified as AF prevalent, if they had received at least two outpatient diagnoses of AF (ICD10-Code I48.1-) in two different quarters of the year and/or had received at least one main AF diagnosis during inpatient treatment between 1 January 2007 and 12 December 2008. They were considered to have had new onset AF in 2008 under the following conditions; first, there was no AF diagnosis in 2007; secondly, patients had not received oral anticoagulant medication in 2007; and thirdly, patients had received either one inpatient/two outpatient diagnoses of AF in 2008. In our sample, a total of 176 891 patients had AF. AF prevalence was 2.132%. The average age of these AF patients was 73.1 years, and 55.5% (98 190 patients) were male. Theincidence of AF in our sample was 4.358 cases/1000 person-years in men and 3.868 cases/1000 person-years in women.Conclusion A comparison of the distribution of AFprevalence/incidence in our population with that in already published studies showed that our figures were higher, especially in the age groups above 70 years. Our data show that in a large industrial nation such as Germany care provision structures are going to be challenged by a requirement to treat more AF patients in the future.