猫茶 发表于 2021-12-10 09:43

糖化血红蛋白是什么?为什么心脏病患者也经常查?

<section><section><section><section data-autoskip="1"><section data-mpa-template="t" mpa-from-tpl="t"><section data-mpa-template="t" mpa-from-tpl="t"><section data-color="#ff8124" mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section data-support="96编辑器" data-style-id="34192"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display:inline-block;"><section style="background-color:#fefefe;display:inline-block;margin-left:35px;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><section style="margin-right:3px;margin-left:auto;height:0px;width: 0px;border-bottom:0.25em solid #ff8d8d;border-right: 0.25em solid transparent !important;border-left: 0.45em solid transparent !important;box-sizing: border-box;margin-bottom: -2px;transform: rotateZ(-51deg);-webkit-transform: rotateZ(-51deg);-moz-transform: rotateZ(-51deg);-ms-transform: rotateZ(-51deg);-o-transform: rotateZ(-51deg);"><br/></section><section style="margin-left:auto;height:0px;width: 0px;border-top: 0.65em solid #ff8d8d;border-left: 0.2em solid transparent !important;border-right: 0.2em solid transparent !important;box-sizing: border-box;transform: rotateZ(75deg);-webkit-transform: rotateZ(75deg);-moz-transform: rotateZ(75deg);-ms-transform: rotateZ(75deg);-o-transform: rotateZ(75deg);"><br/></section></section></section><section style="margin-top: -39px;"><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 64, 64);padding: 3px;border-radius: 50%;display: inline-block;box-sizing: border-box;"><section style="background-color: rgb(255, 248, 244);width: 38px;height: 38px;border-radius: 50%;box-sizing: border-box;"><section style="color:#e70808;line-height:38px;"><p data-form="0" data-num="4">01</p></section></section></section></section></section></section><p style="text-align: center;line-height: 2em;letter-spacing: 1px;"><span style="font-size: 16px;color: rgb(255, 76, 65);">什么是糖化血红蛋白?</span></p></section><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section data-mpa-template="t" mpa-from-tpl="t"><section data-mpa-template="t" mpa-from-tpl="t"><section data-color="#ff8124" mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><br/></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="32915"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display: flex;justify-content: space-between;align-items: center;"><section style="width: 22px;height: 22px;border-top: 1px solid rgb(255, 0, 0);border-left: 1px solid rgb(255, 0, 0);overflow: hidden;box-sizing: border-box;"><br/></section><section style="width: 22px;height: 22px;border-top: 1px solid rgb(255, 0, 0);border-right: 1px solid rgb(255, 0, 0);box-sizing: border-box;"><br/></section></section><section style="margin: -18px 4px;background-color: rgb(254, 245, 245);"><section style="padding: 15px;box-sizing: border-box;"><section style="letter-spacing: 2px;font-size: 14px;color: rgb(103, 103, 103);line-height: 1.75em;text-align: justify;"><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="color: rgb(0, 0, 0);font-size: 16px;">&nbsp; &nbsp; &nbsp; 糖化血红蛋白(HbA1c)是血液中红细胞内血红蛋白与血液中葡萄糖持续且不可逆地进行非酶促蛋白糖基化反应的产物。红细胞内血红蛋白的平均寿命约120天,糖化血红蛋白的生成速度与2~3个月内血糖水平成正比,临床上认为糖化血红蛋白能够反映患者过去2~3个月平均的血糖控制情况。</span><br/></p></section></section></section><section style="display: flex;justify-content: space-between;align-items: center;"><section style="width: 22px;height: 22px;border-bottom: 1px solid rgb(255, 0, 0);border-left: 1px solid rgb(255, 0, 0);overflow: hidden;box-sizing: border-box;"><br/></section><section style="margin-left: auto;width: 22px;height: 22px;border-bottom: 1px solid rgb(255, 0, 0);border-right: 1px solid rgb(255, 0, 0);overflow: hidden;box-sizing: border-box;"><br/></section></section></section></section></section></section></section></section></section></section><section data-mpa-template="t" mpa-from-tpl="t"><section data-mpa-template="t" mpa-from-tpl="t"><section data-color="#ff8124" mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section data-support="96编辑器" data-style-id="34192"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display:inline-block;"><section style="background-color:#fefefe;display:inline-block;margin-left:35px;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><section style="margin-right:3px;margin-left:auto;height:0px;width: 0px;border-bottom:0.25em solid #ff8d8d;border-right: 0.25em solid transparent !important;border-left: 0.45em solid transparent !important;box-sizing: border-box;margin-bottom: -2px;transform: rotateZ(-51deg);-webkit-transform: rotateZ(-51deg);-moz-transform: rotateZ(-51deg);-ms-transform: rotateZ(-51deg);-o-transform: rotateZ(-51deg);"><br/></section><section style="margin-left:auto;height:0px;width: 0px;border-top: 0.65em solid #ff8d8d;border-left: 0.2em solid transparent !important;border-right: 0.2em solid transparent !important;box-sizing: border-box;transform: rotateZ(75deg);-webkit-transform: rotateZ(75deg);-moz-transform: rotateZ(75deg);-ms-transform: rotateZ(75deg);-o-transform: rotateZ(75deg);"><br/></section></section></section><section style="margin-top: -39px;"><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 64, 64);padding: 3px;border-radius: 50%;display: inline-block;box-sizing: border-box;"><section style="background-color: rgb(255, 248, 244);width: 38px;height: 38px;border-radius: 50%;box-sizing: border-box;"><section style="color:#e70808;line-height:38px;"><p data-form="0" data-num="3">02</p></section></section></section></section></section></section><section mpa-from-tpl="t"><p style="line-height: 2em;letter-spacing: 1px;"><span style="font-size: 16px;color: rgb(255, 76, 65);">&nbsp; &nbsp; &nbsp; 简而言之,糖化血红蛋白是评估糖尿病的一个指标,那为什么心脏病患者也会要求查糖化血红蛋白?很多心脏病的诊治指南或专家共识中也会要求查糖化血红蛋白而不仅仅是空腹血糖呢?</span></p></section></section><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section data-mpa-template="t" mpa-from-tpl="t"><section data-mpa-template="t" mpa-from-tpl="t"><section data-color="#ff8124" mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><br/></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="32915"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display: flex;justify-content: space-between;align-items: center;"><section style="width: 22px;height: 22px;border-top: 1px solid rgb(255, 0, 0);border-left: 1px solid rgb(255, 0, 0);overflow: hidden;box-sizing: border-box;"><br/></section><section style="width: 22px;height: 22px;border-top: 1px solid rgb(255, 0, 0);border-right: 1px solid rgb(255, 0, 0);box-sizing: border-box;"><br/></section></section><section style="margin: -18px 4px;background-color: rgb(254, 245, 245);"><section style="padding: 15px;box-sizing: border-box;"><section style="letter-spacing: 2px;font-size: 14px;color: rgb(103, 103, 103);line-height: 1.75em;text-align: justify;"><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(0, 0, 0);">&nbsp; &nbsp; &nbsp; 我们都知道,糖代谢异常(包含糖尿病和空腹血糖调节受损及糖尿病受损)是冠心病等心脑血管疾病发病的重要危险因素。而在中国人群中,还有很大一部分患者表现为空腹血糖正常,而餐后血糖却明显异常,如果仅查一次空腹血糖可能导致很大一部分糖代谢异常的患者未被发现,延误糖代谢异常的诊治,而给患者带来非常巨大的危害。</span></p><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(0, 0, 0);">&nbsp; &nbsp; &nbsp; 另外值得一提的是,当出现急性心梗等危急情况时,由于强烈的应激状态可能导致应激性高血糖,如果单纯依靠当下血糖的检测结果可能导致错误地将这一部分病人归为糖尿病,从而导致过度治疗,甚至因不合理治疗导致严重低血糖等情况诱发心脑血管事件的发生等。而糖化血红蛋白能够反映患者较长时间(2-3个月)平均血糖的水平,联合血糖检测结果,可以综合判断患者糖代谢情况。</span></p><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;color: rgb(0, 0, 0);">&nbsp; &nbsp; &nbsp; 对于心脏病合并糖尿病患者,患者在评估心脏疾患的同时一定要评估血糖控制情况,而糖化血红蛋白就是评估血糖控制优劣的一个有效指标,根据患者年龄、对低血糖的耐受情况、病程、本身疾病状态极预期寿命等综合考虑,每一个患者都会设定个体化的控制目标,目前多数糖尿病指南推荐HbA1c≥7%可作为2型糖尿病启动临床治疗或需要调整治疗方案的重要判断标准。而另外一些如糖尿病病程较长、预期寿命较短、有严重低血糖史、近期发生过急性心脑血管事件、有显著的微血管或大血管并发症,HbA1c控制可适当放宽至&lt;8.0%甚至<8.5%。</span></p></section></section></section><section style="display: flex;justify-content: space-between;align-items: center;"><section style="width: 22px;height: 22px;border-bottom: 1px solid rgb(255, 0, 0);border-left: 1px solid rgb(255, 0, 0);overflow: hidden;box-sizing: border-box;"><br/></section><section style="margin-left: auto;width: 22px;height: 22px;border-bottom: 1px solid rgb(255, 0, 0);border-right: 1px solid rgb(255, 0, 0);overflow: hidden;box-sizing: border-box;"><br/></section></section></section></section></section></section></section></section></section></section></section></section></section></section><section data-mpa-template="t" mpa-from-tpl="t"><section data-mpa-template="t" mpa-from-tpl="t"><section data-color="#ff8124" mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section data-support="96编辑器" data-style-id="34192"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display:inline-block;"><section style="background-color:#fefefe;display:inline-block;margin-left:35px;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><section style="margin-right:3px;margin-left:auto;height:0px;width: 0px;border-bottom:0.25em solid #ff8d8d;border-right: 0.25em solid transparent !important;border-left: 0.45em solid transparent !important;box-sizing: border-box;margin-bottom: -2px;transform: rotateZ(-51deg);-webkit-transform: rotateZ(-51deg);-moz-transform: rotateZ(-51deg);-ms-transform: rotateZ(-51deg);-o-transform: rotateZ(-51deg);"><br/></section><section style="margin-left:auto;height:0px;width: 0px;border-top: 0.65em solid #ff8d8d;border-left: 0.2em solid transparent !important;border-right: 0.2em solid transparent !important;box-sizing: border-box;transform: rotateZ(75deg);-webkit-transform: rotateZ(75deg);-moz-transform: rotateZ(75deg);-ms-transform: rotateZ(75deg);-o-transform: rotateZ(75deg);"><br/></section></section></section><section style="margin-top: -39px;"><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 64, 64);padding: 3px;border-radius: 50%;display: inline-block;box-sizing: border-box;"><section style="background-color: rgb(255, 248, 244);width: 38px;height: 38px;border-radius: 50%;box-sizing: border-box;"><section style="color:#e70808;line-height:38px;"><p data-form="0" data-num="2">03</p></section></section></section></section></section></section><section mpa-from-tpl="t"><p style="text-align: center;line-height: 2em;letter-spacing: 1px;"><span style="font-size: 16px;color: rgb(255, 76, 65);">我们应该多久做一次糖化血红蛋白检测呢?</span></p></section></section><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section data-mpa-template="t" mpa-from-tpl="t"><section data-mpa-template="t" mpa-from-tpl="t"><section data-color="#ff8124" mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><br/></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="32915"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display: flex;justify-content: space-between;align-items: center;"><section style="width: 22px;height: 22px;border-top: 1px solid rgb(255, 0, 0);border-left: 1px solid rgb(255, 0, 0);overflow: hidden;box-sizing: border-box;"><br/></section><section style="width: 22px;height: 22px;border-top: 1px solid rgb(255, 0, 0);border-right: 1px solid rgb(255, 0, 0);box-sizing: border-box;"><br/></section></section><section style="margin: -18px 4px;background-color: rgb(254, 245, 245);"><section style="padding: 15px;box-sizing: border-box;"><section style="letter-spacing: 2px;font-size: 14px;color: rgb(103, 103, 103);line-height: 1.75em;text-align: justify;"><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="color: rgb(0, 0, 0);font-size: 16px;">&nbsp; &nbsp; &nbsp; 糖尿病协会建议在糖尿病治疗之初或血糖控制不满意且需调整方案者,每3个月检测1次HbA1c,血糖控制满意且稳定的糖尿病患者每6个月检测1次HbA1c。另外计划怀孕的糖尿病育龄期女性,初期每月测1次HbA1c,血糖控制满意后,应每6~8周测1次,直到受孕。</span><br/></p></section></section></section><section style="display: flex;justify-content: space-between;align-items: center;"><section style="width: 22px;height: 22px;border-bottom: 1px solid rgb(255, 0, 0);border-left: 1px solid rgb(255, 0, 0);overflow: hidden;box-sizing: border-box;"><br/></section><section style="margin-left: auto;width: 22px;height: 22px;border-bottom: 1px solid rgb(255, 0, 0);border-right: 1px solid rgb(255, 0, 0);overflow: hidden;box-sizing: border-box;"><br/></section></section></section></section></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="34192"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display:inline-block;"><section style="background-color:#fefefe;display:inline-block;margin-left:35px;transform: rotateZ(0deg);-webkit-transform: rotateZ(0deg);-moz-transform: rotateZ(0deg);-ms-transform: rotateZ(0deg);-o-transform: rotateZ(0deg);"><section style="margin-right:3px;margin-left:auto;height:0px;width: 0px;border-bottom:0.25em solid #ff8d8d;border-right: 0.25em solid transparent !important;border-left: 0.45em solid transparent !important;box-sizing: border-box;margin-bottom: -2px;transform: rotateZ(-51deg);-webkit-transform: rotateZ(-51deg);-moz-transform: rotateZ(-51deg);-ms-transform: rotateZ(-51deg);-o-transform: rotateZ(-51deg);"><br/></section><section style="margin-left:auto;height:0px;width: 0px;border-top: 0.65em solid #ff8d8d;border-left: 0.2em solid transparent !important;border-right: 0.2em solid transparent !important;box-sizing: border-box;transform: rotateZ(75deg);-webkit-transform: rotateZ(75deg);-moz-transform: rotateZ(75deg);-ms-transform: rotateZ(75deg);-o-transform: rotateZ(75deg);"><br/></section></section></section><section style="margin-top: -39px;"><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 64, 64);padding: 3px;border-radius: 50%;display: inline-block;box-sizing: border-box;"><section style="background-color: rgb(255, 248, 244);width: 38px;height: 38px;border-radius: 50%;box-sizing: border-box;"><section style="color:#e70808;line-height:38px;"><p data-form="0" data-num="1">04</p></section></section></section></section></section></section><section data-mpa-template="t" mpa-from-tpl="t"><section data-mpa-template="t" mpa-from-tpl="t"><section data-color="#ff8124" mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><section mpa-from-tpl="t"><p style="line-height: 2em;letter-spacing: 1px;"><span style="font-size: 16px;color: rgb(255, 76, 65);">&nbsp; &nbsp; &nbsp; 在临床上也会遇到糖化血红蛋白与血糖结果不符的情况,临床监测血糖很不理想,但糖化血红蛋白却相对正常,这时我们该怎么考虑呢?</span></p></section></section><section mpa-from-tpl="t"><section mpa-from-tpl="t"><br/></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="32915"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display: flex;justify-content: space-between;align-items: center;"><section style="width: 22px;height: 22px;border-top: 1px solid rgb(255, 0, 0);border-left: 1px solid rgb(255, 0, 0);overflow: hidden;box-sizing: border-box;"><br/></section><section style="width: 22px;height: 22px;border-top: 1px solid rgb(255, 0, 0);border-right: 1px solid rgb(255, 0, 0);box-sizing: border-box;"><br/></section></section><section style="margin: -18px 4px;background-color: rgb(254, 245, 245);"><section style="padding: 15px;box-sizing: border-box;"><section style="letter-spacing: 2px;font-size: 14px;color: rgb(103, 103, 103);line-height: 1.75em;text-align: justify;"><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="color: rgb(0, 0, 0);font-size: 16px;">&nbsp; &nbsp; &nbsp; 糖化血红蛋白能不能反映真实情况首先要血红蛋白相对正常,如果出现包括可能存在使红细胞寿命变短的慢性溶血性贫血如地中海贫血、蚕豆病、球形红细胞增多症、椭圆形红细胞增多症、免疫性溶血等;可能存在血红蛋白突然增加的情况如近期大量失血、贫血治疗后;可能存在导致红细胞破坏、丢失增多的因素如脾亢、透析等;当然也有特殊情况,比如暴发性1型糖尿病,由于病程进展快,可能在第一次就诊时可能会出现血糖与糖化血红蛋白分离现象。</span><br/></p><p style="letter-spacing: 1px;line-height: 2.5em;"><span style="color: rgb(0, 0, 0);font-size: 16px;"><br/></span></p><p style="letter-spacing: 1px; line-height: 2.5em; text-align: center;"><span style="color: rgb(0, 0, 0);font-size: 16px;"></span></p></section></section></section><section style="display: flex;justify-content: space-between;align-items: center;"><section style="width: 22px;height: 22px;border-bottom: 1px solid rgb(255, 0, 0);border-left: 1px solid rgb(255, 0, 0);overflow: hidden;box-sizing: border-box;"><br/></section><p style="margin-left: auto; width: 22px; height: 22px; border-bottom: 1px solid rgb(255, 0, 0); border-right: 1px solid rgb(255, 0, 0); overflow: hidden; box-sizing: border-box; text-align: center;"></p></section></section></section><p></p><p></p><section style="white-space: normal;outline: 0px;max-width: 100%;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;background-color: rgb(255, 255, 255);box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: 10px;margin-bottom: 10px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="padding-left: 11px;outline: 0px;max-width: 100%;box-sizing: border-box;display: inline-block;width: 676.994px;vertical-align: top;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;box-sizing: border-box;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);overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: 10px;outline: 0px;max-width: 100%;display: flex;flex-flow: row nowrap;text-align: left;justify-content: flex-start;transform: translate3d(-8px, 0px, 0px);box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;display: inline-block;vertical-align: top;width: auto;line-height: 0;letter-spacing: 0px;flex: 0 0 0%;height: auto;align-self: flex-start;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;text-align: right;justify-content: flex-end;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;display: inline-block;width: 8px;height: 45px;vertical-align: top;overflow: hidden;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;text-align: center;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;width: 7.8267px;height: auto;box-sizing: border-box !important;overflow-wrap: break-word !important;"><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;outline: 0px;max-width: 100%;display: inline-block;vertical-align: top;width: auto;flex: 100 100 0%;align-self: flex-start;height: auto;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;justify-content: flex-start;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="padding-right: 20px;padding-left: 10px;outline: 0px;max-width: 100%;box-sizing: border-box;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;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;color: rgb(7, 48, 196);text-align: center;letter-spacing: 2px;line-height: 2.2;box-sizing: border-box !important;overflow-wrap: break-word !important;"><p style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><strong style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;">联系方式</strong></p></section></section></section></section></section></section><section style="margin-bottom: 10px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="padding-right: 20px;padding-left: 20px;outline: 0px;max-width: 100%;box-sizing: border-box;color: rgb(62, 62, 62);letter-spacing: 1.8px;line-height: 1.8;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;">1、咨询株洲恺德心血管病医院订阅号<strong style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="outline: 0px;max-width: 100%;color: rgb(7, 48, 196);box-sizing: border-box !important;overflow-wrap: break-word !important;">在线客服;</span></strong><br data-filtered="filtered" style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"/>2、咨询电话:<strong style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="outline: 0px;max-width: 100%;color: rgb(7, 48, 196);box-sizing: border-box !important;overflow-wrap: break-word !important;">0731-28260137</span></strong></section><section style="outline: 0px;max-width: 100%;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;">3、联系地址:株洲恺德心血管病医院<span style="outline: 0px;max-width: 100%;color: rgb(7, 48, 196);box-sizing: border-box !important;overflow-wrap: break-word !important;"><strong style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;">第二住院大楼3楼(心血管内三科)</strong></span></section></section></section></section></section></section></section></section><section style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;letter-spacing: 0.544px;text-align: right;font-size: 12px;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: 10px;margin-bottom: 10px;outline: 0px;max-width: 100%;font-size: 16px;letter-spacing: 0.544px;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;box-sizing: border-box;border-top: 1px solid rgb(7, 48, 196);line-height: 0;overflow-wrap: break-word !important;"><section data-filtered="filtered" style="outline: 0px;max-width: 100%;line-height: 0;width: 0px;box-sizing: border-box !important;overflow-wrap: break-word !important;"><svg viewbox="0 0 1 1" style="vertical-align:top;"></svg></section></section><section style="margin-top: 3px;outline: 0px;max-width: 100%;box-sizing: border-box;border-top: 4px solid rgb(7, 48, 196);line-height: 0;overflow-wrap: break-word !important;"><section data-filtered="filtered" style="outline: 0px;max-width: 100%;line-height: 0;width: 0px;box-sizing: border-box !important;overflow-wrap: break-word !important;"><svg viewbox="0 0 1 1" style="vertical-align:top;"></svg></section></section></section><section style="outline: 0px;max-width: 100%;letter-spacing: 0.544px;box-sizing: border-box !important;overflow-wrap: break-word !important;"><p style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="outline: 0px;max-width: 100%;letter-spacing: 0.544px;box-sizing: border-box !important;overflow-wrap: break-word !important;">文案:刘平平</span><span style="outline: 0px;max-width: 100%;letter-spacing: 0.544px;font-size: 17px;text-align: justify;box-sizing: border-box !important;overflow-wrap: break-word !important;"></span></p></section></section></section></section><p></p><h2 style="font-weight: bold;white-space: normal;outline: 0px;max-width: 100%;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, 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