冠狀動脈疾病

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冠狀動脈疾病
coronary artery disease
同义词 Atherosclerotic heart disease,[1]atherosclerotic vascular disease,[2]coronary heart disease[3]
Blausen 0257 CoronaryArtery Plaque.png
冠狀動脈粥樣(atherosclerosis)硬化示意圖
醫學專科 心臟病學心脏外科
症状 胸痛呼吸困难[4]
併發症 心臟衰竭心律不整[5]
肇因 心臟的動脈英语Coronary arteries 粥樣硬化[6]
風險因子英语Risk factor 高血壓吸菸糖尿病、缺乏運動、肥胖症高膽固醇血症[6][7]
診斷方法 心电图cardiac stress test英语cardiac stress test, coronary computed tomographic angiography英语coronary computed tomographic angiography, coronary angiogram英语Coronary catheterization[8]
預防 健康的飲食、規律運動、維持健康的體重、不吸菸[9]
治療 Percutaneous coronary intervention (PCI), coronary artery bypass surgery (CABG)[10]
藥物 Aspirin, beta blockers, nitroglycerin英语Medical use of nitroglycerin[10]
盛行率 1.1 億 (2015)[11]
死亡數
冠狀動脈疾病
分类和外部资源
醫學專科 心臟內科心脏外科
ICD-10 I20 -I25
ICD-9-CM 410-414, 429.2
MedlinePlus [1]
eMedicine [2]
Patient UK 冠狀動脈疾病
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[13]冠狀動脈粥狀硬化心臟病[14]冠狀動脈粥狀硬化心血管疾病英语:coronary atherosclerotic heart disease, CAHD[15]冠狀動脈心臟病英语:coronary heart disease[16],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[17]。冠狀動脈疾病是最常見的心臟血管疾病[18]。常見的症狀包括胸痛或不適,有時會轉移到肩膀、手臂、背部、頸部或下顎[4]。有些人可能會有胸口灼熱的感覺[4]。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[4]。有時會伴隨呼吸困難,有時則是毫無症狀[4]。少數人以心肌梗塞為最初的表現[5]。其他可能的併發症包含心臟衰竭心律不整[5]

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、營養不良和酗[6][19]。其他的危險因子也包括憂鬱症[20]。潛在的病理機制與冠狀動脈血管粥狀硬化有關[6]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[21]

預防方式包括:健康飲食、規律運動、體重控制以及戒菸[9]。視情況合併使用藥物控制高血糖、高膽固醇或高血壓[9]。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[22]。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[10][23]。進一步的藥物治療包括阿斯匹靈乙型交感神經阻斷劑硝酸甘油的醫療用途[10]。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[10][24]。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[25]

冠狀動脈疾病在西元2012年是全球第一大死因[26],也是人們住院的主要原因之一[27]。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%)[18]。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[28]。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[29]。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%[30]。針對同一年齡層相比,男性的發生率較女性高[30]

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。冠狀動脈被膽固醇或血凝塊阻塞時,會形成斑塊而引致心臟供血不足,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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  7. ^ 引用错误:没有为名为Meh2014的参考文献提供内容
  8. ^ 引用错误:没有为名为NIH2014Diag的参考文献提供内容
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外部連結[编辑]