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[OCC2013]稳定型冠心病的诊断策略:病情决定治疗决策

2013-05-27 OCC2013 OCC2013

稳定型冠心病指的是斑块大部分是稳定的,如果无引起足够的狭窄或者冠脉血流受阻,那么患者应该以内科药物干预动脉粥样硬化,控制危险因素,加强他汀类治疗为主。临床实践以及临床研究均证实了他汀类药物、抗血小板药物、抗凝药物等药物能有效降低冠心病死亡率。但是所谓稳定与不稳定都是相对的,正如我们所说的运动和静止一样,不能偷换这个哲学的基本概念,其二,稳定型冠心病在一定程度上能转变成不稳定型冠心病,虽然稳定型冠心

稳定型冠心病指的是斑块大部分是稳定的,如果无引起足够的狭窄或者冠脉血流受阻,那么患者应该以内科药物干预动脉粥样硬化,控制危险因素,加强他汀类治疗为主。临床实践以及临床研究均证实了他汀类药物、抗血小板药物、抗凝药物等药物能有效降低冠心病死亡率。但是所谓稳定与不稳定都是相对的,正如我们所说的运动和静止一样,不能偷换这个哲学的基本概念,其二,稳定型冠心病在一定程度上能转变成不稳定型冠心病,虽然稳定型冠心病的冠脉斑块是稳定的,但是当患者在运动等需氧较多的情况下,耗氧量增加,进而出现冠脉缺血症状,此时是应该积极的血运重建干预。如果狭窄部位位于冠脉的重要部位比如前降支的近端根部,一旦不稳定,患者的死亡率极高的,所以类似这样的稳定斑块也可以看做是“定时炸弹”,引发这个“炸弹”会带来严重的后果,就要积极干预。所以要科学全面的分析稳定性冠心病患者的具体病情。

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    2013-05-29 zhaojie88
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