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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]
冠状动脉粥样(atherosclerosis)硬化示意图
症状胸痛呼吸困难[4]
并发症心脏衰竭心律不整[5]
类型动脉疾病[*]心血管疾病疾病
病因心脏的动脉英语Coronary arteries 粥样硬化[6]
风险因素高血压吸烟糖尿病、缺乏运动、肥胖症高胆固醇血症[6]
诊断方法心电图心脏压力测试英语cardiac stress test, 冠状动脉血管电脑断层扫描英语coronary computed tomographic angiography, 冠状动脉血管摄影英语Coronary catheterization
预防健康的饮食、规律运动、维持健康的体重、不吸烟[7]
治疗经皮冠状动脉介入治疗 (PCI), 冠状动脉旁路移植 (CABG)[8]
药物阿司匹林, β受体阻滞剂, 硝酸甘油英语医用硝酸甘油[8]
患病率1.1 亿 (2015)[9]
死亡数
分类和外部资源
医学专科心脏病学心脏外科
ICD-9-CM410-414.99、​414.0、​414.9、​414.00
OMIM300464、​607339、​608316、​608318、​608320、​610947、​611139、​612030、​614293
MedlinePlus007115
eMedicine349040
[编辑此条目的维基数据]

冠状动脉疾病coronary artery disease,CAD)简称冠心病,是涉及心脏动脉的斑块堆积(动脉粥样硬化)导致流向心肌的血流降低,为最常见的心血管疾病[11]

冠心病有许多异名近义词,如:冠状动脉心脏病coronary heart disease,CHD)[12][13]缺血性心脏病ischemic heart disease,IHD)[14]心肌缺血(myocardial ischemia)、冠状动脉粥样硬化心脏病coronary atherosclerotic heart disease,CAHD)[15][16]冠状动脉粥样硬化心血管疾病[17]

冠心病型态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[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。有些人可能会有胸口灼热的感觉。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。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。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冠状动脉血管摄影英语Coronary catheterization(一种血管摄影)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[7]。视情况合并使用药物控制高血糖、高胆固醇或高血压[7]。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[8][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[8]。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[8][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]

冠状动脉疾病在西元2002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%)[11]。而随著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,尤其在已开发国家更为显著[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%。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”(粤语打通用的气球)的血管扩张手术以气球扩张冠状动脉,使之畅通。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,须立即口含医师处方的“脷底丸”(粤语舌下丸之义),其可扩张血管,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]

手术治疗[编辑]

参考资料[编辑]

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外部链接[编辑]