什么是动脉粥样硬化?

动脉粥样硬化动脉的增厚或硬化. It is caused by a buildup of plaque in the inner lining of an artery. 

 

斑块是由脂肪物质沉积而成, 胆固醇, 细胞废物, calcium, 和纤维蛋白. As it builds up in the arteries, the artery walls become thickened and stiff.

动脉粥样硬化 is a slow, progressive disease that may start as early as childhood. 然而，它可以迅速发展.

什么导致动脉粥样硬化?

目前还不清楚动脉粥样硬化是如何开始的，也不清楚是什么导致了它. However, a gradual buildup of plaque or thickening due to inflammation occurs on the inside of the walls of the artery. This reduces blood flow and oxygen supply to the vital body organs and extremities.

动脉粥样硬化的危险因素是什么?

动脉粥样硬化的危险因素包括:

• 高胆固醇和甘油三酯水平

• 高血压

• Smoking

• 1型糖尿病

• Obesity

• 缺乏身体活动

• 高饱和脂肪饮食

动脉粥样硬化的症状是什么?

动脉粥样硬化的体征和症状可逐渐发展, 可能很少, 随着斑块在动脉中逐渐积聚. 症状也可能因受影响的动脉而异. However, 当大动脉堵塞时, 症状和体征可能很严重, 比如心脏病发作时, stroke, 或者血凝块.

The symptoms of atherosclerosis may look like other heart conditions. 请向您的医疗保健提供者咨询诊断.

如何诊断动脉粥样硬化?

First, your doctor will do a complete medical history and physical exam. 您还可以进行以下一项或多项测试:

• 心导管检查. With this procedure, a long thin tube (catheter) is passed into the coronary arteries. X-rays are taken after a dye is injected into an artery to locate the narrowing, 堵塞, 以及其他特定动脉的异常.

• 多普勒超声. A special probe is used to direct sound waves into a blood vessel to evaluate blood flow. An audio receiver amplifies the sound of the blood moving though the vessel. 模糊或听不到声音可能意味着有堵塞. This is used to identify narrowing of the blood vessels of the abdomen, neck, or legs.

• 血压比较. Comparing blood pressure measurements in the ankles and in the arms helps determine any constriction in blood flow. Significant differences may mean blood vessels are narrowed due to atherosclerosis.

• 蒙加/放射性核素血管造影术. This is a nuclear scan to see how the heart wall moves and how much blood is expelled with each heartbeat, 当人在休息时.

• 铊/心肌灌注扫描. This is a nuclear scan given while the person is at rest or after exercise that may reveal areas of the heart muscle that are not getting enough blood.

• 计算机断层扫描. This is a type of X-ray test that can see if there is coronary calcification that may suggest a future heart problem. 

动脉粥样硬化是如何治疗的?

Treatment for atherosclerosis may include lifestyle changes, medicine, and surgery.

生活方式的改变

You can change some risk factors for atherosclerosis such as smoking, 高胆固醇水平, 高血糖(葡萄糖)水平, 缺乏锻炼, 不良饮食习惯, 还有高血压.

药物

可用于治疗动脉粥样硬化的药物包括:

• 抗血小板药物. These are medicines used to decrease the ability of platelets in the blood to stick together and cause clots. Aspirin, clopidogrel, ticlopidine, and dipyridamole are examples of antiplatelet medicines.

• 抗凝血剂. 也叫血液稀释剂, these medicines work differently from antiplatelet medicines to decrease the ability of the blood to clot. 华法林和肝素是抗凝血剂的例子.

• 降胆固醇药物. 这些是用来降低血液中脂肪(脂质)的药物, 尤其是低密度脂(LDL)胆固醇. 他汀类药物是一组降胆固醇药物. They include simvastatin, atorvastatin, and pravastatin among others. 胆汁酸的隔离剂——colesvelam, cholestyramine and colestipol—and nicotinic acid are other types of medicine that may be used to reduce 胆固醇 levels. Your doctor may also prescribe fibrates to help improve your 胆固醇 and triglyceride levels.

• 降压药. Several different groups of medicines act in different ways to lower blood pressure.

冠状动脉血管成形术

With this procedure, a long thin tube (catheter) is thread through a blood vessel to the heart. There, a balloon is inflated to create a bigger opening in the vessel to increase blood flow. Although angioplasty is done in other blood vessels elsewhere in the body, percutaneous coronary intervention (PCI) refers to angioplasty in the coronary arteries to permit more blood flow into the heart. PCI手术有几种类型，包括:

• 气囊血管成形术. A small balloon is inflated inside the blocked artery to open the blocked area.

• Atherectomy. The blocked area inside the artery is shaved away by a tiny device on the end of a catheter.

• 激光血管成形术. 一种用于蒸发动脉阻塞物的激光.

• 冠状动脉支架. A tiny mesh coil is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open.

冠状动脉搭桥术

通常被称为搭桥手术, this surgery is often done in people who have angina (chest pain) due to coronary artery disease (where plaque has built up in the arteries). 在手术过程中, a bypass is created by grafting a piece of a healthy vein from elsewhere in the body and attaching it above and below the blocked area of a coronary artery. 这样可以让血液在堵塞的地方流动. 静脉通常取自腿部或胸壁. Sometimes more than one artery needs to be bypassed during the same surgery.

动脉粥样硬化的并发症有哪些?

动脉内的斑块堆积会减少血液流动. A heart attack may occur if the blood supply is reduced to the heart. A damaged heart muscle may not pump as well and can lead to heart failure. 如果大脑的血液供应被切断，就可能发生中风. Severe pain and tissue death may occur if the blood supply is reduced to the arms and legs.

动脉粥样硬化可以预防吗??

你可以通过减少危险因素来预防或延缓动脉粥样硬化. 这包括采用健康的生活方式.  健康饮食, 减肥, 积极锻炼身体, 不吸烟有助于降低动脉粥样硬化的风险. 健康的饮食包括水果, 蔬菜, 全谷物, 瘦肉, 去皮的鸡肉, seafood, 以及无脂或低脂乳制品. 健康饮食 also limits sodium, refined sugars and grains, and solid fats.

如果你有动脉粥样硬化的风险，因为你的家族史, 或者高胆固醇, it is important that you take medicines as directed by your healthcare provider.

我应该什么时候给我的医疗保健提供者打电话?

If your symptoms get worse or you have new symptoms, let your healthcare provider know.

动脉粥样硬化要点

• 动脉粥样硬化 is thickening or hardening of the arteries caused by a buildup of plaque in the inner lining of an artery.

• 风险因素可能包括高胆固醇和甘油三酯水平, 高血压, smoking, 糖尿病, obesity, 体育活动, 吃饱和脂肪.

• 动脉粥样硬化 can cause a heart attack, stroke, aneurysm, 或者血凝块.

• You may need medicine, treatments, or surgery to reduce the complications of atherosclerosis.