冠狀動脈疾病

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(重定向自缺血性心臟病
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冠狀動脈疾病 / Coronary artery disease
分類系統及外部資源

冠狀動脈粥樣硬化示意圖
ICD-10 I20 -I25
ICD-9 410-414, 429.2
MedlinePlus 007115
eMedicine radio/192
MeSH D003324

冠狀動脈疾病英语Coronary artery disease, CAD)又稱為缺血性心臟病或簡稱冠心病英语ischemic heart disease, IHD[1]冠狀動脈粥狀硬化心臟病[2]冠狀動脈粥狀硬化心血管疾病英语coronary atherosclerotic heart disease, CAHD[3]冠狀動脈心臟病英语coronary heart disease[4],是一群包含穩定型心絞痛非穩定型心絞痛英语Unstable angina心肌梗塞猝死的疾病[5]。冠狀動脈疾病是最常見的心臟血管疾病[6]。常見的症狀包括胸痛英语chest pain或不適,有時會轉移到肩膀、手臂、背部、頸部或下顎[7]。有些人可能會有胸口灼熱英语Heartburn的感覺[7]。通常症狀在運動或情緒壓力下出現,持續時間不超過數分鐘且休息會緩解[7]。有時會伴隨呼吸困難,有時則是毫無症狀[7]。少數人以心肌梗塞為最初的表現[8]。其他可能的併發症包含心臟衰竭心律不整[8]

危險因子包括:高血壓抽菸糖尿病、缺乏運動、肥胖血液中膽固醇含量過高英语Hypercholesterolemia、營養不良和酗[9][10]。其他的危險因子也包括憂鬱症[11]。潛在的病理機制與冠狀動脈血管粥狀硬化有關[10]心電圖心臟壓力測試英语Cardiac stress test冠狀動脈血管攝影英语Coronary catheterization是常見有助於診斷的工具[12]

預防方式包括:健康飲食、規律運動、體重控制以及戒菸[13]。視情況合併使用藥物控制高血糖、高膽固醇或高血壓[13]。只有很有限的證據支持對低風險且沒有症狀的民眾實施篩檢[14]。最初治療和預防措施一樣,包括生活方式調整以及三高(高血糖、高膽固醇或高血壓)的控制[15][16]。進一步的藥物治療包括阿斯匹靈乙型交感神經阻斷劑英语Beta_blocker硝酸甘油的醫療用途[16]。在病況較嚴重的情形下,會考慮進行經皮冠狀動脈介入治療或是冠狀動脈繞道手術[16][17]。對於穩定型心絞痛,經皮冠狀動脈介入治療或是冠狀動脈繞道手術,對於提升存活年限或降低未來心臟病發的效果仍不明確[18]

冠狀動脈疾病在西元2012年是全球第一大死因[19],也是人們住院的主要原因之一[20]。2013年也是全球死因首位,死亡人數自1990年574萬人(12%)攀升至2013年814萬人(16.8%)[6]。而隨著診斷及治療技術進步,經年齡校正後的冠狀動脈疾病死亡率自1980年至2010年則呈現下降趨勢,尤其在已開發國家更為顯著[21]。同時經年齡校正後的冠狀動脈疾病病例數在1990至2010年間亦呈現下降趨勢[22]。根據美國本土於2010年統計,冠狀動脈疾病盛行率於大於65歲族群為20%、45至64歲為7%、18至45歲為1.3%[23]。針對同一年齡層相比,男性的發生率較女性高[23]

治疗[编辑]

冠狀動脈是主動脈的分支,負責供應足夠氧和營養素予心肌。冠狀動脈膽固醇或血凝塊阻塞時,會形成噬菌斑便會引致心臟供血不足,患者需要接受俗稱「通波仔」的血管擴張手術以暢通血管。若冠狀動脈血液被嚴重阻塞,可引致很嚴重的後果。血液不能供應到心臟會引致劇烈的心絞痛,然後心臟會衰竭,最嚴重的可導致死亡。當冠心病發作時,須含服醫生處方的「脷底丸」(硝酸甘油),「脷底丸」可扩张血管,以增加冠状动脉血流量。冠心病發作可引致嚴重後果,應立即叫救護車求助。

健康的生活方式[编辑]

药物治疗[编辑]

相關治療手術[编辑]

参考资料[编辑]

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外部連結[编辑]