冠状动脉疾病

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冠状动脉疾病
coronary artery disease
同义词 Atherosclerotic heart disease,[1]atherosclerotic vascular disease,[2]coronary heart disease[3]
Blausen 0257 CoronaryArtery Plaque.png
冠状动脉粥样(atherosclerosis)硬化示意图
医学专科 心脏病学心脏外科
症状 胸痛呼吸困难[4]
并发症 心脏衰竭心律不整[5]
肇因 心脏的动脉英语Coronary arteries 粥样硬化[6]
风险因子英语Risk factor 高血压吸烟糖尿病、缺乏运动、肥胖症高胆固醇血症[6][7]
诊断方法 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]
预防 健康的饮食、规律运动、维持健康的体重、不吸烟[9]
治疗 Percutaneous coronary intervention (PCI), coronary artery bypass surgery (CABG)[10]
药物 Aspirin, beta blockers, nitroglycerin英语Medical use of nitroglycerin[10]
盛行率 1.1 亿 (2015)[11]
死亡数
冠状动脉疾病
分类和外部资源
医学专科 心脏内科心脏外科
ICD-10 I20 -I25
ICD-9-CM 410-414, 429.2
MedlinePlus 007115
eMedicine radio/192
Patient UK 冠状动脉疾病
MeSH D003324

冠状动脉疾病英语:coronary artery disease, CAD)又称为缺血性心脏病或简称冠心病英语:ischemic heart disease, IHD[13]冠状动脉粥状硬化心脏病[14]冠状动脉粥状硬化心血管疾病英语:coronary atherosclerotic heart disease, CAHD[15]冠状动脉心脏病英语:coronary heart disease[16],是一群包含稳定型心绞痛非稳定型心绞痛英语Unstable angina心肌梗塞猝死的疾病[17]。冠状动脉疾病是最常见的心脏血管疾病[18]。常见的症状包括胸痛或不适,有时会转移到肩膀、手臂、背部、颈部或下颚[4]。有些人可能会有胸口灼热的感觉[4]。通常症状在运动或情绪压力下出现,持续时间不超过数分钟且休息会缓解[4]。有时会伴随呼吸困难,有时则是毫无症状[4]。少数人以心肌梗塞为最初的表现[5]。其他可能的并发症包含心脏衰竭心律不整[5]

危险因子包括:高血压抽烟糖尿病、缺乏运动、肥胖血液中胆固醇含量过高、营养不良和酗[6][19]。其他的危险因子也包括忧郁症[20]。潜在的病理机制与冠状动脉血管粥状硬化有关[6]心电图心脏压力测试英语Cardiac stress test冠状动脉血管摄影英语Coronary catheterization是常见有助于诊断的工具[21]

预防方式包括:健康饮食、规律运动、体重控制以及戒烟[9]。视情况合并使用药物控制高血糖、高胆固醇或高血压[9]。只有很有限的证据支持对低风险且没有症状的民众实施筛检[22]。最初治疗和预防措施一样,包括生活方式调整以及三高(高血糖、高胆固醇或高血压)的控制[10][23]。进一步的药物治疗包括阿斯匹灵乙型交感神经阻断剂硝酸甘油的医疗用途[10]。在病况较严重的情形下,会考虑进行经皮冠状动脉介入治疗或是冠状动脉绕道手术[10][24]。对于稳定型心绞痛,经皮冠状动脉介入治疗或是冠状动脉绕道手术,对于提升存活年限或降低未来心脏病发的效果仍不明确[25]

冠状动脉疾病在公元2012年是全球第一大死因[26],也是人们住院的主要原因之一[27]。2013年也是全球死因首位,死亡人数自1990年574万人(12%)攀升至2013年814万人(16.8%)[18]。而随着诊断及治疗技术进步,经年龄校正后的冠状动脉疾病死亡率自1980年至2010年则呈现下降趋势,尤其在发达国家更为显著[28]。同时经年龄校正后的冠状动脉疾病病例数在1990至2010年间亦呈现下降趋势[29]。根据美国本土于2010年统计,冠状动脉疾病盛行率于大于65岁族群为20%、45至64岁为7%、18至45岁为1.3%[30]。针对同一年龄层相比,男性的发生率较女性高[30]

治疗[编辑]

冠状动脉是主动脉的分支,负责供应足够氧和营养素予心肌。冠状动脉被胆固醇或血凝块阻塞时,会形成斑块而引致心脏供血不足,患者需要接受俗称“通波仔”的血管扩张手术以畅通血管。若冠状动脉血液被严重阻塞,可引致很严重的后果。血液不能供应到心脏会引致剧烈的心绞痛,然后心脏会衰竭,最严重的可导致死亡。当冠心病发作时,须含服医生处方的“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。冠心病发作可引致严重后果,应立即叫救护车求助。

健康的生活方式[编辑]

药物治疗[编辑]

相关治疗手术[编辑]

参考资料[编辑]

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外部链接[编辑]