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动脉粥样硬化英语:Atherosclerosis)是一種是粥樣斑塊英语Atheroma沉積在血管壁並造成動脈狹窄的疾病[7]。動脈粥樣硬化的早期通常沒有症狀[1],嚴重時視其影響的動脈所在,可能造成冠狀動脈疾病中風周邊動脈疾病以及腎功能衰竭[1]。一般而言,動脈粥樣硬化的相關症狀在中年之後才會出現[3]

动脉粥样硬化
Atherosclerosis
同義詞 Arteriosclerotic vascular disease (ASVD)
Endo dysfunction Athero.PNG
动脉粥样硬化的病程 (血管狹窄化的放大圖)
醫學專科 心臟病學血管學
症状[1]
併發症 冠狀動脈疾病中風周邊動脈阻塞腎功能衰竭[1]
常見始發於 青年 (並且隨著年紀增加而惡化)[2]
肇因 未知[1]
風險因子英语Risk factor 高血壓糖尿病吸煙肥胖症、家族史、不健康的飲食[3]
預防 健康飲食、規律運動、不抽菸、維持正常體重[4]
藥物 Statin抗高血压药阿司匹林[5]
盛行率 ~100% (高於65歲)[6]
动脉粥样硬化
分类和外部资源
醫學專科 心臟內科
ICD-10 I70
ICD-9-CM 440, 414.0
DiseasesDB 1039
MedlinePlus 000171
eMedicine med/182
Patient UK 动脉粥样硬化
MeSH D050197

目前造成動脈粥樣硬化的原因尚不明朗[1]。相關的風險因子包括血中膽固醇異常高血壓糖尿病吸菸肥胖、動脈粥樣硬化的家族史、以及不健康的飲食習慣[3]。血管壁的斑塊由脂肪膽固醇血栓結締組織、以及其他血中物質組成[7]。斑塊使得血管變得狹窄,含氧血的運送也因此被干擾[7]。動脈粥樣硬化的診斷常包括理學檢查心電圖心臟壓力測試英语Cardiac stress test等等 [8]

預防動脈粥樣硬化的方式一般包括健康飲食、運動、戒菸、以及維持正常體重[4]、用以降低血中膽固醇他汀類藥物抗高血压药,或是阿斯匹靈抗凝血劑都常用來治療動脈粥狀硬化[5]。除了藥物之外,經皮冠狀動脈介入治療冠狀動脈繞道手術、以及頸動脈內膜切除手術等手術也可以用來治療動脈粥樣硬化[5]

動脈粥樣硬化這個疾病最早在1575年就有記載[9],但疾病本身的歷史遠久於此,在超過5000年前的考古證據中就已經有動脈粥樣硬化的蹤跡[9]。動脈粥樣硬化一般在年輕時便已經發生,然後隨著年齡而惡化[2],大多數的老年人(65歲以上)都患有不同程度的動脈粥樣硬化[6]。動脈粥樣硬化是已開發國家排名第一的致死與致殘疾病[10]

目录

病理编辑

在过去很长时间裡动脉硬化始终是医学生物化学研究的重点。其原因是因为它的普及性。许多人有动脉硬化,但是这个状态可以数年、数十年在人体内存在,却不显示出任何病态,然后它会突然以局部缺血、心绞痛心肌梗塞中风心力衰竭等致命病爆发。在发展国家中动脉硬化后果是最常见的死因。[11]

动脉硬化的特征是动脉的慢性退化及动脉壁的逐渐变化。由于结缔组织的增长、细胞内外胆固醇脂肪酸以及碳酸钙的沉积、膠原蛋白蛋白聚糖的聚集动脉壁变硬变厚,动脉变细,整个动脉失去弹性。[12]

当胆固醇等物质堆积到了足够程度时,血管内皮细胞会诱导单核细胞分化为巨噬细胞。巨噬细胞会吞噬血管壁之间的脂肪并使它们堆积于细胞内,脂肪使细胞成为泡沫细胞[13]

主动脉外,常累及心脏的冠状动脉和脑、肾动脉,可以引起动脉粥样斑块破裂、血栓形成,管腔狭窄至闭塞,从而使有关器官的血液供应发生障碍。

由于动脉硬化过程非常复杂,参加的细胞和组织(上皮细胞平滑肌单核细胞巨噬细胞血小板)、分子(脂蛋白生长激素、胆固醇、脂肪、膠原蛋白和细胞因子等)多样,其中关系错综,因此至今为止在医学上没有良好的可以预言动脉硬化的模型和技术。

视频字幕

致病風險因素编辑

通过众多病史学和临床研究至少可以总结出一定的、有利于动脉硬化形成的因素。

後天可變的编辑

後天不可變的编辑

機率偏低未被完全確認编辑

參見编辑

參考來源编辑

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