协和医生说｜冠心病病人私自停用降脂药，小心急性心梗！
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">冠心病是一种<span style="color: black;">平常</span>的心血管<span style="color: black;">疾患</span>，它不仅对<span style="color: black;">病人</span>的生活质量<span style="color: black;">导致</span>重大影响，还可能危及生命。在冠心病的管理中，除了生活方式的改变和必要的医学<span style="color: black;">干涉</span>，<span style="color: black;">长时间</span><span style="color: black;">吃下</span>降脂<span style="color: black;">药品</span><span style="color: black;">亦</span>是一个不可或缺的环节。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">今天，北京协和医院心内科医护人员将为您<span style="color: black;">仔细</span>介绍<span style="color: black;">为何</span>冠心病<span style="color: black;">病人</span><span style="color: black;">必须</span><span style="color: black;">长时间</span><span style="color: black;">吃下</span>降脂药——</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1.<span style="color: black;">出现</span>在身边的案例 </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">三年前，小A<span style="color: black;">由于</span>经常觉得胸口憋闷，到医院<span style="color: black;">检测</span>后被确诊为冠心病。<span style="color: black;">同期</span>，<span style="color: black;">做为</span>血脂指标之一的低密度脂蛋白胆固醇比正常参考值上限略高一点，<span style="color: black;">大夫</span><span style="color: black;">意见</span>她<span style="color: black;">长时间</span><span style="color: black;">吃下</span>降脂药阿托伐他汀——一种冠心病的治疗<span style="color: black;">药品</span>，并嘱咐她<span style="color: black;">每日</span><span style="color: black;">夜晚</span>服药。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">小A半年后去门诊<span style="color: black;">检测</span>，血脂指标都正常了，就擅自停用了阿托伐他汀。此后每次复查，<span style="color: black;">大夫</span>都叮嘱她要<span style="color: black;">保持</span>吃药，她觉得指标都正常了，<span style="color: black;">不必</span>吃药，<span style="color: black;">亦</span>就没听从<span style="color: black;">大夫</span>的嘱咐。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2个月前，小A因冠心病加重，突发急性心肌梗死住院，幸亏当时家里有人，送医<span style="color: black;">即时</span>，才转危为安。<span style="color: black;">无</span>按时吃降脂药的小A被<span style="color: black;">大夫</span><span style="color: black;">发掘</span>后<span style="color: black;">亦</span>被“狠狠批评”了一顿。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q3.itc.cn/q_70/images03/20240509/e0f79934d1a244ebadb078d4903141e8.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">看了这个案例或许您会问：降脂药对冠心病有什么<span style="color: black;">功效</span>吗？<span style="color: black;">为何</span>和小A类似的冠心病<span style="color: black;">病人</span>，即使血脂正常，<span style="color: black;">亦</span>要<span style="color: black;">长时间</span>吃降脂药呢？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">下面就和<span style="color: black;">大众</span>简单说说。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2.冠心病的罪魁祸首 </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">冠心病的全<span style="color: black;">叫作</span>是冠状动脉粥样硬化性心脏病，通俗地讲<span style="color: black;">便是</span>坏的胆固醇在光滑的动脉血管内膜上沉积，形<span style="color: black;">成为了</span>类似米粥<span style="color: black;">同样</span>的堆积物——斑块。这些斑块的生长和<span style="color: black;">成长</span>都和血液中的胆固醇，尤其是低密度脂蛋白胆固醇浓度密切<span style="color: black;">关联</span>，<span style="color: black;">亦</span><span style="color: black;">便是</span>说高胆固醇血症是<span style="color: black;">导致</span>冠心病的罪魁祸首之一。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">血液里的胆固醇就像灰尘，<span style="color: black;">倘若</span>不<span style="color: black;">即时</span>进行<span style="color: black;">掌控</span>和清理，它就会越积越多，在血管里捣乱，<span style="color: black;">导致</span>不可挽回的后果。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q3.itc.cn/q_70/images03/20240509/bac282f6e0fe4e9b8b90abb4ae0cbacc.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">举个例子，<span style="color: black;">咱们</span><span style="color: black;">每一个</span>人都有打扫房间的经历，打扫完房间后，屋里的地面、家具表面都会很干净，<span style="color: black;">无</span>灰尘，<span style="color: black;">无</span>垃圾。<span style="color: black;">倘若</span><span style="color: black;">咱们</span><span style="color: black;">保持</span><span style="color: black;">每日</span>打扫，房间就会保持干净，不会<span style="color: black;">累积</span>灰尘和垃圾。但<span style="color: black;">倘若</span>打扫完一次后，隔一段时间再打扫，就会<span style="color: black;">发掘</span>地面和家具表面又覆盖了<span style="color: black;">非常多</span>灰尘，垃圾<span style="color: black;">亦</span><span style="color: black;">累积</span>了<span style="color: black;">非常多</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">同理，<span style="color: black;">咱们</span>血管上的胆固醇就如同灰尘和垃圾，而身体就像一个大房间。<span style="color: black;">倘若</span>你<span style="color: black;">由于</span><span style="color: black;">各样</span><span style="color: black;">原由</span>，吃了一段时间降脂药，<span style="color: black;">发掘</span>血脂指标正常了，身体<span style="color: black;">亦</span>没不舒服，<span style="color: black;">再也不</span><span style="color: black;">保持</span>吃药，<span style="color: black;">那样</span>坏的胆固醇就会像灰尘垃圾<span style="color: black;">同样</span>，慢慢附着在血管壁上，越积越多。短期内您可能不会有什么感觉，但随着时间延长，就会<span style="color: black;">显现</span><span style="color: black;">各样</span>动脉血管<span style="color: black;">疾患</span>如冠心病、脑卒中等的隐患。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q1.itc.cn/q_70/images03/20240509/23a2242d37844893a8b81346dd671fe1.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3.冠心病家族中的头号杀手 </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">动脉粥样硬化是冠心病发展的核心过程，它是一个缓慢而<span style="color: black;">连续</span>的病理变化。从正常的动脉内膜<span style="color: black;">起始</span>，胆固醇和其他脂质物质<span style="color: black;">逐步</span>沉积，形成脂肪条纹。随着时间的推移，这些脂肪条纹会<span style="color: black;">逐步</span>演化<span style="color: black;">作为</span>更加紧密和纤维化的斑块，即纤维斑块。这些斑块不仅会阻碍血液流动，还可能<span style="color: black;">引起</span>血管壁的进一步<span style="color: black;">损害</span>和炎症反应。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q7.itc.cn/q_70/images03/20240509/b463af31f57440b3984974e155135f91.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">上图<span style="color: black;">表示</span>的<span style="color: black;">便是</span>动脉粥样硬化的形成过程，动脉内膜堆积的胆固醇形成的斑块<span style="color: black;">逐步</span><span style="color: black;">成长</span>，<span style="color: black;">导致</span>血管腔进行性狭窄。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">人体在<span style="color: black;">心情</span>激动、饱餐、冷空气刺激等<span style="color: black;">状况</span>下，冠状动脉管腔内的斑块会<span style="color: black;">忽然</span>破裂，局部<span style="color: black;">显现</span>血栓堆积，冠脉内血流完全中断<span style="color: black;">引起</span>供血区域的心肌坏死，部分<span style="color: black;">病人</span>还来不及<span style="color: black;">看病</span><span style="color: black;">已然</span><span style="color: black;">显现</span>心脏骤停，这<span style="color: black;">便是</span><span style="color: black;">咱们</span>常常谈之色变的急性心肌梗死——冠心病家族中的头号杀手 。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4.降脂药<span style="color: black;">不仅</span>是降脂 </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">小A医嘱<span style="color: black;">吃下</span>的他汀类降脂药<span style="color: black;">能够</span>减少<span style="color: black;">身体</span>有害胆固醇的合成，<span style="color: black;">亦</span>就减少了动脉硬化形成的“原料”。“原料”减少，<span style="color: black;">不仅</span>会延缓动脉粥样硬化斑块的生长速度，<span style="color: black;">乃至</span>还可能使斑块变小，对冠心病起到很好的防治<span style="color: black;">功效</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">还有<span style="color: black;">科研</span><span style="color: black;">显示</span>，他汀类<span style="color: black;">药品</span><span style="color: black;">能够</span>使<span style="color: black;">已然</span>形成的动脉硬化斑块变得更稳定，降低其<span style="color: black;">忽然</span>破裂的可能，<span style="color: black;">这般</span>自然就降低了心肌梗死的发病<span style="color: black;">危害</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q2.itc.cn/q_70/images03/20240509/a811ac31770a4419bd8fd8b30e679d26.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">5.“黄金时间”服药<span style="color: black;">一样</span><span style="color: black;">要紧</span> </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因为</span>夜间血液中胆固醇的浓度相对更高，<span style="color: black;">因此</span>医师会<span style="color: black;">意见</span>在<span style="color: black;">夜晚</span>或睡前<span style="color: black;">吃下</span>他汀类降脂<span style="color: black;">药品</span>，从而尽可能压制它们破坏血管。有研究比较了<span style="color: black;">区别</span>时间<span style="color: black;">吃下</span>他汀类降脂<span style="color: black;">药品</span>的疗效，观察到同等剂量的降脂<span style="color: black;">药品</span>，<span style="color: black;">夜晚</span><span style="color: black;">吃下</span>时降低血液中低密度脂蛋白胆固醇的幅度较<span style="color: black;">白日</span><span style="color: black;">吃下</span>时<span style="color: black;">加强</span>3%～5%。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q9.itc.cn/q_70/images03/20240509/cc22b6de90b444c8a22b3ca557d8d210.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">6.总结 </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对</span>冠心病<span style="color: black;">病人</span>而言，<span style="color: black;">长时间</span><span style="color: black;">吃下</span>降脂<span style="color: black;">药品</span>不仅是为了<span style="color: black;">掌控</span>血脂水平，<span style="color: black;">更加是</span>为了减少斑块的形成和增长，稳定已有的斑块，从而降低心血管事件的<span style="color: black;">危害</span>。这一过程就像<span style="color: black;">定时</span>清理房间<span style="color: black;">同样</span>，<span style="color: black;">必须</span><span style="color: black;">连续</span>的<span style="color: black;">奋斗</span>和<span style="color: black;">守护</span>，以保持血管的健康和通畅。<span style="color: black;">经过</span>遵医嘱，<span style="color: black;">保持</span>规范用药，<span style="color: black;">病人</span>能够有效地<span style="color: black;">掌控</span>冠心病，<span style="color: black;">加强</span>生活质量，享受更加健康的生活。</p>
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