猫茶 发表于 2021-9-6 13:30

高血压患者多久查一次血脂呢?您见过这样的血脂谱吗?

<h2 style="font-weight: bold;white-space: normal;line-height: 1.6em;"><br/></h2><p></p><section><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;">&nbsp; &nbsp; &nbsp; 最近门诊接到一个35岁的男性,主诉“乏力”,入诊室后我出于医生的敏感性我一眼就看到了他眼角长的黄色瘤。</span></p><p style="text-align: center;"></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>立马就想到这个应该是个高脂血症患者,于是就安排他进行糖脂代谢的检查;检查结果如下:</span></p><section data-support="96编辑器" data-style-id="31845"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-width: 1px 4px;border-style: solid;border-color: rgb(255, 146, 146);padding: 13px;border-radius: 10px;box-sizing: border-box;"></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>看到这个结果你是否震撼了呢?但事实上临床上经常会碰到这么震人心魄的血脂。</span></p><section data-mpa-template="t" mpa-from-tpl="t"><section data-support="96编辑器" data-style-id="33213"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display:inline-block;"><section style="background-image: linear-gradient(135deg, #fc7979 50%, #fda1a1 50%);box-sizing: border-box;border-radius:40px;"><section style="padding: 3px 10px 3px 15px;box-sizing: border-box;"><section style="display: flex;align-items: center;"><section style="width:1em;"></section><section style="margin-right: 5px;margin-left: 10px;"><section><section style="font-size: 18px;letter-spacing: 2px;color: rgb(255, 255, 255);"><p><span style="font-size: 16px;"><strong>一、什么原因导致了高脂血症?</strong></span></p></section></section></section></section></section></section></section></section></section><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section data-support="96编辑器" data-style-id="31585"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="margin-left: auto;width: 2em;"><br/></section><section style="margin-top: -30px;margin-right: 10px;padding: 14px;background-color: rgb(255, 251, 251);border-radius: 0px 20px 0px 0px;box-sizing: border-box;"><section style="line-height: 1.75em;letter-spacing: 2px;font-size: 15px;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>高脂血症按照病因分类为继发性高脂血症或原发性高脂血症。</span></p><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(255, 76, 65);"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>继发性高脂血症是指由于不良生活方式或其他疾病所引起的血脂异常</span><span style="font-size: 16px;">。它们主要包括高能量、高脂和高糖饮食,过度饮酒,肥胖,糖尿病、肾病综合征、甲状腺功能减退症、肾功能衰竭、肝脏疾病、系统性红斑狼疮、糖原累积症、骨髓瘤、脂肪萎缩症、急性朴啉病、多囊卵巢综合征等。还有一些人是因为长期服用某些药物如利尿剂、非心脏选择性β受体阻滞剂、糖皮质激素等。</span></p><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>在排除继发性高脂血症后,即可诊断为原发性高脂血症。大部分原发性高脂血症是由于单一或多个基因突变所致,多呈家族聚集性,有明显的遗传倾向,特别是单一基因突变者,通常被称为家族性高脂血症。</span></p><p style="letter-spacing: 1px;line-height: 2.5em;text-align: center;"><span style="font-size: 16px;"></span></p></section></section></section></section></section></section></section></section><section data-mpa-template="t" mpa-from-tpl="t"><section data-support="96编辑器" data-style-id="33213"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display:inline-block;"><section style="background-image: linear-gradient(135deg, #fc7979 50%, #fda1a1 50%);box-sizing: border-box;border-radius:40px;"><section style="padding: 3px 10px 3px 15px;box-sizing: border-box;"><section style="display: flex;align-items: center;"><section style="width:1em;"></section><section style="margin-right: 5px;margin-left: 10px;"><section><section style="font-size: 18px;letter-spacing: 2px;color: rgb(255, 255, 255);"><p><span style="font-size: 16px;"><strong>二、高脂血症有什么危害?</strong></span></p></section></section></section></section></section></section></section></section></section><section data-mpa-template="t" mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section data-support="96编辑器" data-style-id="32512"><section style="margin-top: 10px;margin-bottom: 10px;"><section><section data-support="96编辑器" data-style-id="27930"><section style="margin-top: 10px;margin-bottom: 10px;text-align: left;"><section style="display: inline-block;"><section><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>为什么那么多人会谈“脂”色变呢?</section></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="31585"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="margin-left: auto;width: 2em;"><br/></section><section style="margin-top: -30px;margin-right: 10px;padding: 14px;background-color: rgb(255, 251, 251);border-radius: 0px 20px 0px 0px;box-sizing: border-box;"><section style="line-height: 1.75em;letter-spacing: 2px;font-size: 15px;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(255, 76, 65);"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>《中国成人血脂异常防治指南》</span><span style="font-size: 16px;">指出:胆固醇(TC)从<3.63mmol/l开始,随着逐渐升高,缺血性心血管病发病危险升高,其关系呈现连续性并无拐点,其中TC在5.18-6.19mmol/l时,缺血性心血管病的发病危险较TC<3.63mmol/l时升高50%左右,而TC在6.22mmol/l以上时,缺血性心血管病危险比TC<3.63mmol/l者呈倍数增高。高密度脂蛋白(HDL-C)作为体内血管唯一保护性血脂成分,它的切点值是在1.04-1.55mmol/l间为相对妥善,高于或低于这个范围值都会增加缺血性心血管病危险,其中低于下限值比高于上限值比较,缺血性心血管病危险增加50%。甘油三脂(TG)小于1.7mmol/l为正常,当TG≥2.26mmol/l时为升高,当TG≥5.65mmol/l时有自发性胰腺炎倾向,因此对于TG≥5.65mmol/l的患者通常首选将甘油三酯降至相对安全状态。</span></p></section></section></section></section></section></section></section></section><p style="letter-spacing: 1px;line-height: 2em;"></p></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>高脂血症作为心血管病危险因素之一,防治高脂血症显得至关重要,高血压患者对血脂的要求极其严格,<span style="color: rgb(255, 76, 65);">那么我们在诊治过程中应该如何监测自己的血脂呢?是一个月、三个月还是半年、一年呢?</span></span></p><section data-mpa-template="t" mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section data-support="96编辑器" data-style-id="31585"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="margin-left: auto;width: 2em;"><br/></section><section style="margin-top: -30px;margin-right: 10px;padding: 14px;background-color: rgb(255, 251, 251);border-radius: 0px 20px 0px 0px;box-sizing: border-box;"><section style="line-height: 1.75em;letter-spacing: 2px;transform: rotateZ(0deg);"><p style="font-size: 15px;letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>首先,在确诊为高血压的同时就应该检测血脂、脂蛋白和栽脂蛋白水平,根据基线水平制定相应的干预策略;</span></p><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">(1)</span><span style="font-size: 16px;">如果患者血脂谱位于正常范围且无其他心血管风险,至少每年检测一次血脂;</span></p><p style="font-size: 15px;letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">(2)</span><span style="font-size: 16px;">如果患者血脂谱正常且有多重心血管危险因素(男性≥45岁或女性≥55岁、吸烟、肥胖和早发缺血性心血管病家族史等),应当经常检查血脂,一旦异常及时开始调脂治疗;</span></p><p style="font-size: 15px;letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">(3)</span><span style="font-size: 16px;">对于血脂谱异常的高血压患者,饮食与非药物治疗后3-6个月复查血脂水平,如血脂控制达标则继续原有治疗方式,但仍需每6个月-1年复查,长期达标后可考虑每年复查一次。</span></p></section></section></section></section></section></section></section></section><p></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;color: rgb(255, 76, 65);"><span style="font-size: 16px;letter-spacing: 1px;">&nbsp; &nbsp; &nbsp;&nbsp;</span>服用调脂类药物时,需注意:</span></p><section data-mpa-template="t" mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section data-support="96编辑器" data-style-id="31585"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="margin-left: auto;width: 2em;"><br/></section><section style="margin-top: -30px;margin-right: 10px;padding: 14px;background-color: rgb(255, 251, 251);border-radius: 0px 20px 0px 0px;box-sizing: border-box;"><section style="line-height: 1.75em;letter-spacing: 2px;font-size: 15px;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">(1)</span><span style="font-size: 16px;">首次服用调脂药者,应在服药后6周内复查血脂,且应复查转氨酶和肌酸激酶,评估调脂效果及药物并发症,若ALT、AST升高>3×参考值上限或血CK升高>5×参考值上限,建议暂停他汀类调脂药物并加用护肝等药物、密切监测相关指标,后期换用其他类别的调脂药物;</span></p><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">(2)</span><span style="font-size: 16px;">若血脂达到目标值且无药物不良反应,逐步改为每6-12个月复查1次;</span></p><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">(3)</span><span style="font-size: 16px;">若血脂未达标且无药物不良反应者,每3个月监测1次;</span></p><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(255, 76, 65);">(4)</span><span style="font-size: 16px;">治疗3-6个月血脂认为达标,则需调脂调脂药物剂量或种类,或联合应用不同作用机制的调脂药,每当调整调脂药物种类或剂量时,都应在治疗6周内复查。</span></p></section></section></section></section></section></section></section></section></section><section data-style-id="30285" 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="padding-top: 20px;padding-bottom: 20px;box-sizing: border-box;"><section style="display: flex;justify-content: space-between;align-items: flex-start;"><section><p style="margin-right: 10px;margin-bottom: -10px;margin-left: auto;width: 1px;height: 60px;background-color: rgb(255, 0, 0);"></p><p style="margin-right: 10px;margin-bottom: -10px;margin-left: auto;width: 1px;height: 60px;background-color: rgb(255, 0, 0);"><br/></p><p style="margin-right: 10px;margin-bottom: -10px;margin-left: auto;width: 1px;height: 60px;background-color: rgb(255, 0, 0);"><br/></p><p style="margin-right: 10px;margin-bottom: -10px;margin-left: auto;width: 1px;height: 60px;background-color: rgb(255, 0, 0);"><br/></p></section></section></section></section><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><section style="margin-top: 10px;margin-bottom: 10px;"><section style="padding-left: 11px;display: inline-block;width: 676.994px;vertical-align: top;box-sizing: border-box;"><section><section style="display: inline-block;width: 665.997px;vertical-align: top;background-color: rgba(255, 255, 255, 0);border-style: solid;border-width: 1px;border-radius: 0px;border-color: rgb(7, 48, 196);box-sizing: border-box;"><section><section style="margin-top: 10px;display: flex;flex-flow: row nowrap;text-align: left;justify-content: flex-start;transform: translate3d(-8px, 0px, 0px);"><section style="display: inline-block;vertical-align: top;width: auto;line-height: 0;letter-spacing: 0px;flex: 0 0 0%;height: auto;align-self: flex-start;"><section style="text-align: right;justify-content: flex-end;"><section style="display: inline-block;width: 8px;height: 45px;vertical-align: top;overflow: hidden;"><section style="text-align: center;"><section style="vertical-align: middle;display: inline-block;line-height: 0;width: 7.8267px;height: auto;"><svg xmlns="http://www.w3.org/2000/svg" x="0px" y="0px" viewbox="0 0 1.5 8.7" style="vertical-align: middle;width: 100%;" width="100%" data-width="100%"><g><path d="M1.5,0.2C0.8,0.2,0.2,0.6,0.2,1v6.2C0.5,6.9,1,6.8,1.5,6.8V0.2z" fill="rgb(255,255,255)"></path></g><g><path d="M0.2,7.7H0V1c0-0.5,0.7-1,1.5-1v0.2C0.8,0.2,0.2,0.6,0.2,1v6.2C0.5,6.9,1,6.8,1.5,6.8V7C0.8,7,0.2,7.3,0.2,7.7   z" fill="rgb(7,48,196)"></path></g><g><path d="M1.5,8.7C0.7,8.7,0,8.3,0,7.7s0.7-0.9,1.5-0.9V7C0.8,7,0.2,7.3,0.2,7.7s0.6,0.7,1.3,0.7V8.7z" fill="rgb(7,48,196)"></path></g><g><path d="M1.5,7C0.8,7,0.2,7.3,0.2,7.7s0.6,0.7,1.3,0.7V7z" fill="#5f9cef"></path></g></svg></section></section></section></section></section><section style="margin-left: -1px;display: inline-block;vertical-align: top;width: auto;flex: 100 100 0%;align-self: flex-start;height: auto;"><section style="justify-content: flex-start;"><section style="padding-right: 20px;padding-left: 10px;display: inline-block;vertical-align: top;overflow: hidden;height: 36px;width: auto;min-width: 10%;border-width: 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 data-filtered="filtered"/>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><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 data-filtered="filtered" 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 data-filtered="filtered" 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><span style="letter-spacing: 0.544px;font-size: 17px;text-align: justify;"></span></p></section></section></section></section><p></p><h2 style="font-weight: bold;white-space: normal;line-height: 1.6em;"><br/></h2><p><br/></p><link rel="stylesheet" href="//bbs.zhuzhou.com/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_g9W" id="wcn_editor_css"/>

跳跳糖直率 发表于 2021-9-6 13:41

所以说不管是老人还是小孩,还是中年青年都要有良好的生活习惯,不然一身的毛病

liaobo911 发表于 2021-9-6 15:23

肥肉少吃????

不加任何人 发表于 2021-9-6 16:04

我就是最害怕得病。

liaobb 发表于 2021-9-7 07:05

中国人血脂高是很多的

JG7779 发表于 2021-9-7 07:53

看来平常应该注意下饮食了。

xintuo 发表于 2021-9-7 08:37

长知识了

风云天下,唯我 发表于 2021-9-7 10:55

两个月一次

ameh 发表于 2021-9-8 17:24

血脂高,不可怕。网上可查到依血脂异标状况日服10mg或20mg他汀类降脂药。效果很好,但需坚持用药。我一般服药半年后和查肝功能一起查血脂,和血糖(服他汀药付作用必查肝与血糖项)。很容易达到血脂正常的。
页: [1]
查看完整版本: 高血压患者多久查一次血脂呢?您见过这样的血脂谱吗?