得了心衰到底有多严重？还能活多久？
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">“<span style="color: black;">大夫</span>，我的爷爷<span style="color: black;">近期</span>总是说心累，我看他<span style="color: black;">呼气</span>急促，走一点路就上气不接下气，<span style="color: black;">况且</span>他说<span style="color: black;">近期</span>排尿<span style="color: black;">亦</span>少了，这是什么<span style="color: black;">原由</span>？”</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心力<span style="color: black;">衰尽</span>，简<span style="color: black;">叫作</span>心衰，<span style="color: black;">指的是</span>由<span style="color: black;">各样</span><span style="color: black;">原由</span><span style="color: black;">引起</span>的心脏泵血功能受损，<span style="color: black;">亦</span>是心脏<span style="color: black;">疾患</span>发展的终末<span style="color: black;">周期</span>。在我国35岁以上的居民中，<span style="color: black;">大概</span>1370万心衰<span style="color: black;">病人</span>。而<span style="color: black;">做为</span>心衰的高危人群，80岁以上老人心衰患病率接近12%，<span style="color: black;">大概</span>370万人<span style="color: black;">上下</span>。老年心衰<span style="color: black;">病人</span><span style="color: black;">出现</span>心衰恶化和再入院的<span style="color: black;">危害</span>高，高龄是心衰<span style="color: black;">病人</span>预后差的危险<span style="color: black;">原因</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">非常多</span><span style="color: black;">疾患</span>都会<span style="color: black;">引起</span>心衰的<span style="color: black;">出现</span>，<span style="color: black;">例如</span>高血压、冠心病、先心病、心肌炎、糖尿病、甲亢等。其中高血压占比达到了47.6%，血脂<span style="color: black;">反常</span>达到了34.4%，慢性肾脏病达到了17.1%。（1）</p>
<h2 style="color: black; text-align: left; margin-bottom: 10px;">左心衰？右心衰？还有一个全心衰</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">按照</span>心衰的位置不同，<span style="color: black;">能够</span>分为左心衰、右心衰和全心衰，而心衰的位置不同、程度不同，所<span style="color: black;">引起</span>的症状<span style="color: black;">亦</span>会略有不同。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">咱们</span><span style="color: black;">能够</span>把人体的血液循环系统想象成一个大的车间，其中<span style="color: black;">咱们</span>的心脏<span style="color: black;">便是</span>中转中枢，血液经由肺部加氧之后经由左心传送到人体各个器官组织，再由右心将含氧量低的血液进行回收。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此</span>左心衰<span style="color: black;">便是</span>送氧系统<span style="color: black;">显现</span>了问题，有氧血液从肺部到心脏到全身的运输<span style="color: black;">显现</span>了问题，左心衰就表现为肺淤血、<span style="color: black;">呼气</span>困难等<span style="color: black;">关联</span>症状；而右心衰是血液回收<span style="color: black;">显现</span>了问题，就会<span style="color: black;">显现</span>下肢浮肿、肝肿大（肝淤血）、腹胀（胃肠道淤血）等体循环淤血症状。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">全心衰<span style="color: black;">便是</span>既<span style="color: black;">显现</span>了左心衰的症状，<span style="color: black;">亦</span><span style="color: black;">显现</span>了右心衰的症状，在治疗上就<span style="color: black;">必须</span><span style="color: black;">同期</span>对症治疗。全心衰<span style="color: black;">病人</span>多见于严重的扩张型心肌病、缺血性心肌病以及瓣膜病等<span style="color: black;">疾患</span>，<span style="color: black;">亦</span>有<span style="color: black;">由于</span>感染<span style="color: black;">引起</span>，在左心衰的<span style="color: black;">基本</span>上诱发了全心衰，<span style="color: black;">此时</span><span style="color: black;">病人</span>的<span style="color: black;">呼气</span>困难症状会有所减轻，但这并不是病情好转的信号，而是<span style="color: black;">由于</span>右心衰后，右心排血量减少，相应的肺淤血程度减轻，但这其实是病情更加严重了，<span style="color: black;">必须</span>多加<span style="color: black;">警觉</span>，<span style="color: black;">即时</span><span style="color: black;">看病</span>。</p>
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<h2 style="color: black; text-align: left; margin-bottom: 10px;">心衰到底有多严重？</h2>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">按照</span>美国心脏病学会和美国心脏学会提出的心衰分期概念，心衰可分为4期：A期<span style="color: black;">表率</span>有得心衰的<span style="color: black;">危害</span>，但心脏功能和结构还是正常的，<span style="color: black;">亦</span><span style="color: black;">无</span>心衰的症状；B期<span style="color: black;">表率</span>心脏<span style="color: black;">关联</span><span style="color: black;">检测</span>结果<span style="color: black;">表示</span>出了问题，<span style="color: black;">然则</span>病人还<span style="color: black;">无</span>胸闷、气短的感觉；C期<span style="color: black;">表率</span>了病人<span style="color: black;">已然</span><span style="color: black;">显现</span>了心衰的相应症状，<span style="color: black;">关联</span>的心脏<span style="color: black;">检测</span><span style="color: black;">亦</span><span style="color: black;">发掘</span>了问题，<span style="color: black;">必须</span><span style="color: black;">连续</span>治疗了；而D期<span style="color: black;">便是</span>最严重的了，治疗效果<span style="color: black;">欠好</span>，症状<span style="color: black;">亦</span>很严重，<span style="color: black;">必须</span>特殊治疗，<span style="color: black;">乃至</span>心脏移植。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic3.zhimg.com/80/v2-32ca84600806d91ff4c9487f49588cc6_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">A、B期重在预防，C期加强治疗，防止向D期的<span style="color: black;">发展</span>。<span style="color: black;">处在</span>A~B期的人群则不影响存活率，<span style="color: black;">处在</span>C期的5年<span style="color: black;">存活</span>率在50%<span style="color: black;">上下</span>，而D期<span style="color: black;">病人</span>的预后效果不<span style="color: black;">阳光</span>，5年<span style="color: black;">存活</span>率<span style="color: black;">少于</span>50%。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">心衰<span style="color: black;">掌控</span>的<span style="color: black;">重要</span>，还是在于<span style="color: black;">药品</span>治疗，监控健康状态，健康<span style="color: black;">膳食</span>，<span style="color: black;">处在</span>纽约心脏协会心功能分级I~III级的稳定性心衰<span style="color: black;">病人</span><span style="color: black;">能够</span>在<span style="color: black;">大夫</span>的<span style="color: black;">指点</span>下开展运动<span style="color: black;">恢复</span>。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-0fd18d2c7f5eb6d1c6598880058efae3_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考文献：（1）Guang Hao, XinWang, Zuo Chen, et al. Prevalence of heart failure and left ventricular dysfunction in China: the China Hypertension Survey, 2012–2015. Eur J Heart Fail. 2019; 21(11): 1329-1337. doi:10.1002/ejhf.1629.</p>
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