糖尿病患者什么时候需要服用阿司匹林呢？
<h2 style="font-weight: bold;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);line-height: 1.6em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br/></h2><p><section data-support="96编辑器" data-style-id="31585" style="outline: 0px;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;white-space: normal;"><section style="margin-top: 10px;margin-bottom: 10px;outline: 0px;"><section style="margin-left: auto;outline: 0px;width: 2em;"><br data-filtered="filtered" style="outline: 0px;"/></section><section style="margin-top: -30px;margin-right: 10px;padding: 14px;outline: 0px;background-color: rgb(255, 246, 246);border-radius: 0px 20px 0px 0px;box-sizing: border-box;"><section style="outline: 0px;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="outline: 0px;letter-spacing: 1px;line-height: 2.5em;"><span style="outline: 0px;font-size: 16px;color: #000000;"> 糖尿病是心血管疾病的独立危险因素，糖尿病患者发生心血管疾病的风险增加2-4倍。糖尿病常合并高血压、血脂紊乱等心血管疾病的重要危险因素。糖尿病患者心血管疾病主要包括动脉粥样硬化性心血管疾病（ASCVD）和心力衰竭，其中ASCVD包括冠心病（包括急性冠脉综合征、稳定性冠心病等）、脑血管疾病（缺血性脑卒中、短暂性脑缺血发作）和周围血管疾病，而糖尿病患者的心血管疾病也是糖尿病患者的主要死亡原因。而对多重危险因素的综合干预可显著改善糖尿病患者心血管疾病的发生和死亡风险。</span></p></section></section></section></section><section data-support="96编辑器" data-style-id="34657"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 0, 0);padding: 15px;box-sizing: border-box;"><section style="margin-top: 10px;text-align: center;"><br/></section></section></section></section><section data-support="96编辑器" data-style-id="24136"><section style="margin: 5px 10px;width: 100%;" data-width="100%"><section style="display:inline-block;"><section style="display: flex;justify-content: flex-start;align-items: center;padding-top: 1em;padding-bottom: 1em;box-sizing: border-box;"><section style="border-style:solid;border-width:1px;border-color:#ff0f00;display:inline-block;padding:1px;transform: rotateZ(45deg);-webkit-transform: rotateZ(45deg);-moz-transform: rotateZ(45deg);-ms-transform: rotateZ(45deg);-o-transform: rotateZ(45deg);"><section style="background-color: rgb(255, 15, 0);border-radius: 50%;padding-right: 8px;padding-left: 8px;transform: rotateZ(-45deg);"><p><span style="color: #ffffff;" data-form="0" data-num="1">1</span></p></section></section><section style="border-width: 2px;border-bottom-style: solid;border-color: rgb(255, 15, 0);padding-top: 3px;padding-bottom: 3px;box-sizing: border-box;"><section style="border-width: 1px;border-bottom-style: solid;border-color: rgb(255, 15, 0);padding-right: 15px;padding-left: 15px;box-sizing: border-box;"><p style="letter-spacing:2px;"><span style="color: #ff0f00;">阿司匹林是属于抗血小板聚集的药物，为什么糖尿病患者有些也需要服用阿司匹林呢？</span></p></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="31585" style="outline: 0px;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;white-space: normal;"><section style="margin-top: 10px;margin-bottom: 10px;outline: 0px;"><section style="margin-left: auto;outline: 0px;width: 2em;"><br data-filtered="filtered" style="outline: 0px;"/></section><section style="margin-top: -30px;margin-right: 10px;padding: 14px;outline: 0px;background-color: rgb(255, 246, 246);border-radius: 0px 20px 0px 0px;box-sizing: border-box;"><section style="outline: 0px;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="outline: 0px;letter-spacing: 1px;line-height: 2.5em;"><span style="outline: 0px;font-size: 16px;color: #000000;"> 糖尿病患者，长期高血糖会对人体血管造成一定程度的损害，更容易产生动脉粥样硬化斑块。而当血管里的斑块在外界因素的作用下，发生了破裂，血小板就会参与形成血栓，阻碍正常的血流，甚至导致血管完全闭塞。这样就会造成相应的器官缺血、缺氧、坏死，导致如短暂性脑缺血发作、脑卒中、心梗等急性心脑血管事件的发生。临床上应用阿司匹林的目的是为了抑制体内血小板的过度聚集，从而降低心脑血管事件的发生风险。</span></p></section></section></section></section><section data-support="96编辑器" data-style-id="34657"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 0, 0);padding: 15px;box-sizing: border-box;"><section style="margin-top: 10px;text-align: center;"><br/></section></section></section></section><section data-support="96编辑器" data-style-id="24136"><section style="margin: 5px 10px;width: 100%;" data-width="100%"><section style="display:inline-block;"><section style="display: flex;justify-content: flex-start;align-items: center;padding-top: 1em;padding-bottom: 1em;box-sizing: border-box;"><section style="border-style:solid;border-width:1px;border-color:#ff0f00;display:inline-block;padding:1px;transform: rotateZ(45deg);-webkit-transform: rotateZ(45deg);-moz-transform: rotateZ(45deg);-ms-transform: rotateZ(45deg);-o-transform: rotateZ(45deg);"><section style="background-color: #ff0f00;border-radius: 50%;padding-right: 8px;padding-left: 8px;transform: rotateZ(-45deg);-webkit-transform: rotateZ(-45deg);-moz-transform: rotateZ(-45deg);-ms-transform: rotateZ(-45deg);-o-transform: rotateZ(-45deg);"><p><span style="color: #ffffff;" data-form="0" data-num="1">2</span></p></section></section><section style="border-width: 2px;border-bottom-style: solid;border-color: rgb(255, 15, 0);padding-top: 3px;padding-bottom: 3px;box-sizing: border-box;"><section style="border-width: 1px;border-bottom-style: solid;border-color: rgb(255, 15, 0);padding-right: 15px;padding-left: 15px;box-sizing: border-box;"><p style="letter-spacing:2px;"><span style="color: #ff0f00;">糖尿病患者中，哪些需要使用抗血小板聚集类药物，哪些不需要呢？</span></p></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="31585" style="outline: 0px;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;white-space: normal;"><section style="margin-top: 10px;margin-bottom: 10px;outline: 0px;"><section style="margin-left: auto;outline: 0px;width: 2em;"><br data-filtered="filtered" style="outline: 0px;"/></section><section style="margin-top: -30px;margin-right: 10px;padding: 14px;outline: 0px;background-color: rgb(255, 246, 246);border-radius: 0px 20px 0px 0px;box-sizing: border-box;"><section style="outline: 0px;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="outline: 0px;letter-spacing: 1px;line-height: 2.5em;"><span style="outline: 0px;font-size: 16px;color: #000000;"> </span><span style="font-size: 16px;">《中国2型糖尿病防治指南（2020年版）》指出。对于糖尿病患者合并ASCVD（比如糖尿病合并冠心病、合并脑梗死、合并闭塞性脉管炎等）需要应用小剂量阿司匹林（75-150mg/d）作为二级预防，但同时需要评估出血风险，不能耐受阿司匹林或对阿司匹林过敏的患者建议使用氯吡格雷替代；年龄≥50岁而且合并至少一项主要危险因素（早发ASCVD家族史（指男性一级亲属在55岁之前，女性一级直系家属在65岁前患缺血性心血管病）、高血压、血脂异常、吸烟或慢性肾脏病/蛋白尿）且无出血高风险的的糖尿病合并ASCVD高危患者应用小剂量阿司匹林作为一级预防。</span></p><p style="outline: 0px;letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;"> 糖尿病合并ASCVD低危风险患者（如年龄＜50岁患者，糖尿病不伴有ASCVD危险因素）不建议使用阿司匹林；年龄＜16岁的患者禁止使用阿司匹林。</span></p><p style="outline: 0px;letter-spacing: 1px;line-height: 2.5em;"><span style="font-size: 16px;"> 0非老年患者伴1个或多个危险因素，或老年人不伴危险因素应考虑患者服药意愿等具体评估是否服用；年龄＞70岁或＜50岁的人群，是否服用阿司匹林需要根据个体化评估。</span></p></section></section></section></section><section data-support="96编辑器" data-style-id="34657"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 0, 0);padding: 15px;box-sizing: border-box;"><section style="margin-top: 10px;text-align: center;"><br/></section></section></section></section><section data-support="96编辑器" data-style-id="24136"><section style="margin: 5px 10px;width: 100%;" data-width="100%"><section style="display:inline-block;"><section style="display: flex;justify-content: flex-start;align-items: center;padding-top: 1em;padding-bottom: 1em;box-sizing: border-box;"><section style="border-style:solid;border-width:1px;border-color:#ff0f00;display:inline-block;padding:1px;transform: rotateZ(45deg);-webkit-transform: rotateZ(45deg);-moz-transform: rotateZ(45deg);-ms-transform: rotateZ(45deg);-o-transform: rotateZ(45deg);"><section style="background-color: #ff0f00;border-radius: 50%;padding-right: 8px;padding-left: 8px;transform: rotateZ(-45deg);-webkit-transform: rotateZ(-45deg);-moz-transform: rotateZ(-45deg);-ms-transform: rotateZ(-45deg);-o-transform: rotateZ(-45deg);"><p><span style="color: #ffffff;" data-form="0" data-num="1">3</span></p></section></section><section style="border-width: 2px;border-bottom-style: solid;border-color: rgb(255, 15, 0);padding-top: 3px;padding-bottom: 3px;box-sizing: border-box;"><section style="border-width: 1px;border-bottom-style: solid;border-color: rgb(255, 15, 0);padding-right: 15px;padding-left: 15px;box-sizing: border-box;"><p style="letter-spacing:2px;"><span style="color: #ff0f00;">阿司匹林是什么时候服用呢？早上服用还是晚上服用？</span></p></section></section></section></section></section></section><section data-support="96编辑器" data-style-id="31585" style="outline: 0px;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;white-space: normal;"><section style="margin-top: 10px;margin-bottom: 10px;outline: 0px;"><section style="margin-left: auto;outline: 0px;width: 2em;"><br data-filtered="filtered" style="outline: 0px;"/></section><section style="margin-top: -30px;margin-right: 10px;padding: 14px;outline: 0px;background-color: rgb(255, 246, 246);border-radius: 0px 20px 0px 0px;box-sizing: border-box;"><section style="outline: 0px;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="outline: 0px;letter-spacing: 1px;line-height: 2.5em;"><span style="outline: 0px;font-size: 16px;color: #000000;"> 目前阿司匹林主要有非肠溶剂型（平片和泡腾片）、肠溶剂型和肠溶缓释剂型；阿司匹林肠溶片建议晨起空腹服用效果最好，而普通剂型建议早餐后服用，减轻药物的消化道副作用。</span><span style="font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;font-size: 16px;"></span></p></section></section></section></section><section data-style-id="30285" 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="padding-top: 20px;padding-bottom: 20px;outline: 0px;max-width: 100%;box-sizing: border-box;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;display: flex;justify-content: space-between;align-items: flex-start;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="outline: 0px;max-width: 100%;width: 60px;height: 1px;background-color: rgb(255, 0, 0);box-sizing: border-box !important;overflow-wrap: break-word !important;"><br/></section></section></section></section></section></p><p 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;background-color: rgb(255, 255, 255);letter-spacing: 1px;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;"></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: 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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><h2 style="font-weight: bold;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);line-height: 1.6em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br/></h2><p><br/></p><link rel="stylesheet" href="//bbs.zhuzhou.com/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_hMk" id="wcn_editor_css"/>
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