发际线和我做对 发表于 2021-5-24 14:04

打呼噜可不能忽视,很可能患有这种疾病!

<p><br/></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">&nbsp; &nbsp; &nbsp; 您夜间是否鼾声如雷?您夜间是否反复觉醒?您是否夜尿增多?是否起床后感头昏头痛?精神不济坐着都打瞌睡?</span></p><p><section><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"></span></p><section data-support="96编辑器" data-style-id="25962"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="width:50px;height:5px;background-color:#f20000;"><br/></section><section style="border-width: 2px;border-bottom-style: solid;border-color: rgb(242, 0, 0);padding-top: 3px;padding-bottom: 3px;box-sizing: border-box;"><p style="letter-spacing: 2px;"><span style="color: #f20000;">如果有这些症状,你再看看以下这些情况:</span></p></section><section style="margin-top: 8px;margin-bottom: 8px;"><p></p></section></section></section></section><section data-support="96编辑器" data-style-id="23168"><section><section><section><section><section data-support="96编辑器" data-style-id="26999"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-style: dashed dashed dashed solid;border-color: #d92142;border-width: 1px 1px 1px 4px;padding: 10px;box-sizing: border-box;"><p style="font-size: 15px;letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(0, 0, 0);">1、肥胖:体重超过标准体重的20%或以上,体重指数≥25kg/kg^2;<br/>2、年龄:成年后随年龄增长患病率增加;女性绝经后患者增多,70岁以后患病率趋于稳定;<br/>3、性别:生育期内男性患病率明显高于女性;<br/>4、上呼吸道解剖异常;包括鼻腔阻塞、扁桃体肿大、软腭松弛等;<br/>5、OSAHS家族史;<br/>6、长期吸烟;<br/>7、其他相关疾病:包括甲状腺功能减退、肢端肥大症、心功能不全、脑卒中、胃食管反流或神经肌肉疾病等。</span><br/></p></section><section style="display: flex;justify-content: flex-end;"><section style="width: 16%;height: 2px;background: #d92142;margin-top: -2px;" data-width="16%"><br/></section></section></section></section></section></section></section></section></section></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>如果有,那么请注意,可能你已经罹患下面这种疾病。</span></p><p></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>阻塞性睡眠呼吸暂停低通气综合征(OSAHS),俗称鼾症。是指患者在睡眠中反复出现呼吸暂停和低通气导致低氧血症和高碳酸血症的反复发作以及睡眠障碍。临床上可表现为打鼾,且鼾声不规律,患者自觉憋气,甚至反复被憋醒,常伴夜尿增多,晨起头痛,头晕和口咽干燥等一系列症候群。OSAHS是继发性高血压的常见原因,流行病学研究表明有30~50%的高血压患者合并存在不同程度OSAHS,而在难治性高血压患者中,OSAHS则更为常见,占比可达82%。</span></p><p><section><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"></span></p><section data-support="96编辑器" data-style-id="25962"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="width:50px;height:5px;background-color:#f20000;"><br/></section><section style="border-width: 2px;border-bottom-style: solid;border-color: #f20000;padding-top: 3px;padding-bottom: 3px;box-sizing: border-box;"><p style="letter-spacing: 2px;"><span style="color: #f20000;">那么,OSAHS是怎么样引起高血压的呢?</span><br/></p></section></section></section><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"></span></p></section><section><section><section><section><section data-support="96编辑器" data-style-id="23168"><section><section><section><section><section data-support="96编辑器" data-style-id="26999"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-style: dashed dashed dashed solid;border-color: rgb(217, 33, 66);border-width: 1px 1px 1px 4px;padding: 10px;box-sizing: border-box;"><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>OSAHS会导致反复发作的呼吸道痉挛,剧烈的吸气,胸腔内压力波动,低氧血症,高碳酸血症和呼吸暂停终止时的觉醒,而复发性呼吸暂停可能与高血压的发展有关,</span><span style="font-size: 16px;">可能机制如下:</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">1、间歇性的低血氧饱和度会过度激活RAAS系统,导致水钠潴留;</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">2、由于OSAHS导致的低氧血症、高碳酸血症和其他生理病理反应可能会损害血管内皮功能,从而导致血管顺应性下降和血压升高;</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">3、在未经治疗的OSAHS患者中,夜间和白天的交感系统均处于兴奋中,而交感兴奋会引起心率、心输出量和外周血管阻力增加进而增高血压;</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">&nbsp; &nbsp; &nbsp; 最后,OSAHS引起的缺氧会加剧体内的氧化应激,从而影响血压。</span></p></section><section style="display: flex;justify-content: flex-end;"><section style="width: 16%;height: 2px;background: #d92142;margin-top: -2px;" data-width="16%"><br/></section></section></section></section></section></section></section></section></section></section></section></section></section><section><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"></span></p><section data-support="96编辑器" data-style-id="25962"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="width:50px;height:5px;background-color:#f20000;"><br/></section><section style="border-width: 2px;border-bottom-style: solid;border-color: #f20000;padding-top: 3px;padding-bottom: 3px;box-sizing: border-box;"><p style="letter-spacing: 2px;"><span style="color: #f20000;">除了引起血压升高,OSAHS对健康的危害还有哪些呢?</span><br/></p></section></section></section><p style="letter-spacing: 1px;line-height: 2em;"></p><section data-support="96编辑器" data-style-id="23168"><section><section><section><section><section data-support="96编辑器" data-style-id="26999"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-style: dashed dashed dashed solid;border-color: rgb(217, 33, 66);border-width: 1px 1px 1px 4px;padding: 10px;box-sizing: border-box;"><p style="font-size: 15px;letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">1、脑卒中,OSAHS显著增加脑卒中的发生率</span></p><section><article data-use="1"><section><section><section><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>大规模流行病学研究显示睡眠呼吸暂停次数与缺血性脑卒中的发病密切相关,OSAHS人群发生脑卒中的几率是对照组的4.33倍,死亡率是对照组的1.98倍。<br/></span></p></section></section></section></article></section><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">2、OSAHS对代谢影响</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>主要表现为胰岛素抵抗、糖尿病和血脂代谢紊乱。流行病学显示OSAHS与糖代谢紊乱及糖尿病密切相关,二者有很高共患率,特别是肥胖人群。资料显示,OSAHS患者总糖尿病患病率>40%,而糖尿病患者中OSAHS人群的研究证实患者空腹血糖增高,胰岛素抵抗和糖尿病发生率远高于健康人群。</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>血脂异常 OSAHS患者的高血脂与呼吸暂停持续时间、AHI、夜间动脉血氧分压降低程度和持续时间有关,且随着OSAHS程度的加重而改变;OSAHS患者HDL保护LDL不被氧化的能力降低;OSAHS还可调整和修饰体内LDL和胆固醇的过氧化形式,成为动脉粥样硬化的重要成分。</span></p></section><section style="display: flex;justify-content: flex-end;"><section style="width: 16%;height: 2px;background: #d92142;margin-top: -2px;" data-width="16%"><br/></section></section></section></section></section></section></section></section></section><p><span style="font-size: 16px;"></span></p></section><section><section><section><section data-support="96编辑器" data-style-id="23168"><section><section><section><section><section data-support="96编辑器" data-style-id="26999"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-style: dashed dashed dashed solid;border-color: rgb(217, 33, 66);border-width: 1px 1px 1px 4px;padding: 10px;box-sizing: border-box;"><p style="font-size: 15px;letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">3、消化系统的损害</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">&nbsp; &nbsp; &nbsp; 以胃食管反流最为突出,多项调查证实OSAHS人群的胃食管反流诊治发生率在50%~76%,24小时食道PH监测显示53.4%的反流事件与睡眠呼吸暂停和低氧相关。</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">4、呼吸系统疾病</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">&nbsp; &nbsp; &nbsp; 慢性阻塞性肺疾病:与OSAHS均为常见的呼吸疾病,二者并存率很高,被称为“重叠综合征”。OSAHS患者 22%伴有COPD,而COPD患者中29%~40%患OSAHS。</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>哮喘:研究证实OSAHS患者哮喘患病率为35.1%。哮喘患者37%伴习惯性打鼾,40%具有高度OSAHS可能,这种OSAHS伴习惯性打鼾,这种OSAHS发生率与哮喘的严重程度相关。</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>实际上OSAHS对身体的损害远不止这些,患者的日间嗜睡会导致严重的生产和交通事故。此外OSAHS还对泌尿生殖、内分泌、神经、血液等系统造成损害。</span></p></section><section style="display: flex;justify-content: flex-end;"><section style="width: 16%;height: 2px;background: #d92142;margin-top: -2px;" data-width="16%"><br/></section></section></section></section></section></section></section></section></section></section></section></section><section><section data-support="96编辑器" data-style-id="25962"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="width:50px;height:5px;background-color:#f20000;"><br/></section><section style="border-width: 2px;border-bottom-style: solid;border-color: #f20000;padding-top: 3px;padding-bottom: 3px;box-sizing: border-box;"><p style="letter-spacing: 2px;"><span style="color: #f20000;">OSAHS如蝼蚁,但足以溃败健康这个千里之堤,既然OSAHS那么多危害,那么究竟该怎么治疗呢?</span><br/></p></section></section></section><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"></span></p></section><section><article data-use="1"><section><section><section><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>2013年,由中国医师协会高血压专业委员会联合中华医学会呼吸病学分会睡眠呼吸障碍学组发布了《阻塞性睡眠呼吸暂停相关性高血压临床诊断和治疗专家共识》。共识推荐治疗:</span></p><section><section><section><section data-support="96编辑器" data-style-id="23168"><section><section><section><section><section data-support="96编辑器" data-style-id="26999"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-style: dashed dashed dashed solid;border-color: rgb(217, 33, 66);border-width: 1px 1px 1px 4px;padding: 10px;box-sizing: border-box;"><p style="font-size: 15px;letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">1、一般治疗</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>调整生活方式:控制体重,改变睡姿,尽可能多的时间保持侧卧以利于减轻气道阻塞,同时建议戒烟戒酒,不服用镇静类药物,避免白天过度劳累。</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"></span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">2、呼吸机治疗</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">&nbsp; &nbsp; &nbsp; 呼吸机持续气道正压通气模式(CPAP)治疗,CPAP治疗能够显著提高OSAHS患者的睡眠质量,改善睡眠结构。</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">3、药物治疗</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">&nbsp; &nbsp; &nbsp; 水钠潴留是高血压发病的重要原因,也是OSAHS患者夜间气道阻塞的常见原因。因此利尿剂为基础的降压治疗方案可能更适合此类患者。</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">4、手术治疗</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>对于耳鼻喉或口腔科能通过手术解除或缓解上气道阻塞的患者可考虑。对于中重度OSAHS患者,推荐术前进行CPAP治疗,提高患者麻醉耐受性,还可减少术中出血和术后并发症。</span></p></section><section style="display: flex;justify-content: flex-end;"><section style="width: 16%;height: 2px;background: #d92142;margin-top: -2px;" data-width="16%"><br/></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></article></section></p><p><section data-style-id="30285"><section style="padding-top: 20px;padding-bottom: 20px;box-sizing: border-box;"><section style="margin:-40px 20px;"><section><section><p style="text-align: center;"><br/></p><p style="text-align: center;"><br/></p></section></section></section><section style="display: flex;justify-content:space-between;align-items:flex-start;"><section><section style="width:60px;height:1px;background-color:#f00;margin-left:auto;"><br/></section></section></section></section></section></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"></span></p><p style="white-space: normal;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 1px;line-height: 2em;"><br/></p><p><section style="white-space: normal;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;"><section style="font-family: -apple-system-font, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;font-size: 16px;"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="padding-left: 11px;display: inline-block;width: 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1px;border-bottom-right-radius: 100px;border-style: solid solid solid none;border-color: rgb(7, 48, 196) rgb(7, 48, 196) rgb(7, 48, 196) rgb(138, 50, 222);border-top-right-radius: 100px;border-bottom-left-radius: 0px;box-sizing: border-box;"><section style="color: rgb(7, 48, 196);text-align: center;letter-spacing: 2px;line-height: 2.2;"><p><strong>联系方式</strong></p></section></section></section></section></section></section><section style="margin-bottom: 10px;"><section style="padding-right: 20px;padding-left: 20px;color: rgb(62, 62, 62);letter-spacing: 1.8px;line-height: 1.8;box-sizing: border-box;"><section style="line-height: 2em;">1、咨询株洲恺德心血管病医院订阅号<strong><span style="color: rgb(7, 48, 196);">在线客服;</span></strong><br/>2、咨询电话:<strong><span style="color: rgb(7, 48, 196);">0731-28265873</span></strong></section><section style="line-height: 2em;">3、联系地址:株洲恺德心血管病医院<span style="color: rgb(7, 48, 196);"><strong>第三住院大楼2楼(心血管内三科)</strong></span></section></section></section></section></section></section></section></section><section style="font-family: -apple-system-font, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;"><section style="letter-spacing: 0.544px;text-align: right;font-size: 12px;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 16px;letter-spacing: 0.544px;"><section style="border-top: 1px solid rgb(7, 48, 196);line-height: 0;box-sizing: border-box;"><section style="line-height: 0;width: 0px;"><svg viewbox="0 0 1 1" style="vertical-align:top;"></svg></section></section><section style="margin-top: 3px;border-top: 4px solid rgb(7, 48, 196);line-height: 0;box-sizing: border-box;"><section style="line-height: 0;width: 0px;"><svg viewbox="0 0 1 1" style="vertical-align:top;"></svg></section></section></section><section style="letter-spacing: 0.544px;"><p><span style="letter-spacing: 0.544px;">文案:刘平平</span></p></section></section><p><br/></p></section></section></p><p><br/></p><link rel="stylesheet" href="//bbs.zhuzhou.com/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_Q3f" id="wcn_editor_css"/>
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