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中国头颈部动脉粥样硬化诊治共识:这三类人应该吃他汀

2017-10-10 卢芳 中国循环杂志

中国慢病前瞻性研究一项新的分析显示,中国有三分之一成人存在颈动脉粥样硬化斑块。对于颈动脉粥样硬化,该怎么办?

中国慢病前瞻性研究一项新的分析显示,中国有三分之一成人存在颈动脉粥样硬化斑块。对于颈动脉粥样硬化,该怎么办?近期,中华医学会神经病学分会、中华医学会神经病学分会脑血管病学组就此发布了《中国头颈部动脉粥样硬化诊治共识》。共识指出,如果一个人发生过缺血性中风,无论仅仅是有颈动脉内中膜增厚,还是仅有狭窄不严重的斑块,都建议使用他汀类药物治疗。其次,如果从形态学上判断颈动脉斑块不稳定,或者狭窄>50%,无论血脂是否异常,也都建议使用他汀类药物治疗,使LDL-C控制在1.8 mmol/L以下。如果有颈动脉斑块伴斑块狭窄,但狭窄不到50%,也没有缺血性中风,血脂也不高,可根据斑块的稳定性个体化选用他汀类药物治疗。但如果仅仅是颈动脉内中膜增厚,没有缺血性中风,就控制高血压、糖尿病、血脂异常和吸烟饮酒等相关危险因素即可。如果血脂在正常范围以内,不建议使用他汀类药物治疗。该指南也对颈内动脉剥脱术和颈动脉支架植入术也做了相应推荐。原始出处:中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国头颈部动脉粥样硬化诊治共识. 中华神经科杂志, 2017, 50: 572-578.

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1944494, encodeId=d8141944494d5, content=<a href='/topic/show?id=411de6300ad' target=_blank style='color:#2F92EE;'>#粥样硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76300, encryptionId=411de6300ad, topicName=粥样硬化)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b30d401, createdName=huangshifeng, createdTime=Tue Feb 27 21:55:00 CST 2018, time=2018-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=252017, encodeId=18de25201ee0, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Wed Oct 11 19:55:03 CST 2017, time=2017-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1491800, encodeId=1a7c1491800ff, content=<a href='/topic/show?id=b4f14442346' target=_blank style='color:#2F92EE;'>#头颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44423, encryptionId=b4f14442346, topicName=头颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b2d8903151, createdName=wshxjq, createdTime=Wed Oct 11 15:55:00 CST 2017, time=2017-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589734, encodeId=10cc1589e3415, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Wed Oct 11 15:55:00 CST 2017, time=2017-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=251690, encodeId=0cba25169057, content=你看实名认证了大家发言多么和谐, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLJUicgP739INvgkzTYsTUxNjAWx8qDjSzQJibnBH1tkJhsn5LdiaibBCG1dwJI6pLB0EHa3Qjx5ODh8A/0, createdBy=86d82167010, createdName=Anarkia, createdTime=Tue Oct 10 09:44:13 CST 2017, time=2017-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=251665, encodeId=6760251665fd, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Tue Oct 10 07:00:26 CST 2017, time=2017-10-10, status=1, ipAttribution=)]
    2017-10-11 戒馋,懒,贪

    谢谢分享.学习了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1944494, encodeId=d8141944494d5, content=<a href='/topic/show?id=411de6300ad' target=_blank style='color:#2F92EE;'>#粥样硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76300, encryptionId=411de6300ad, topicName=粥样硬化)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b30d401, createdName=huangshifeng, createdTime=Tue Feb 27 21:55:00 CST 2018, time=2018-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=252017, encodeId=18de25201ee0, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Wed Oct 11 19:55:03 CST 2017, time=2017-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1491800, encodeId=1a7c1491800ff, content=<a href='/topic/show?id=b4f14442346' target=_blank style='color:#2F92EE;'>#头颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44423, encryptionId=b4f14442346, topicName=头颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b2d8903151, createdName=wshxjq, createdTime=Wed Oct 11 15:55:00 CST 2017, time=2017-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589734, encodeId=10cc1589e3415, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Wed Oct 11 15:55:00 CST 2017, time=2017-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=251690, encodeId=0cba25169057, content=你看实名认证了大家发言多么和谐, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLJUicgP739INvgkzTYsTUxNjAWx8qDjSzQJibnBH1tkJhsn5LdiaibBCG1dwJI6pLB0EHa3Qjx5ODh8A/0, createdBy=86d82167010, createdName=Anarkia, createdTime=Tue Oct 10 09:44:13 CST 2017, time=2017-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=251665, encodeId=6760251665fd, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Tue Oct 10 07:00:26 CST 2017, time=2017-10-10, status=1, ipAttribution=)]
    2017-10-11 wshxjq
  4. [GetPortalCommentsPageByObjectIdResponse(id=1944494, encodeId=d8141944494d5, content=<a href='/topic/show?id=411de6300ad' target=_blank style='color:#2F92EE;'>#粥样硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76300, encryptionId=411de6300ad, topicName=粥样硬化)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b30d401, createdName=huangshifeng, createdTime=Tue Feb 27 21:55:00 CST 2018, time=2018-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=252017, encodeId=18de25201ee0, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Wed Oct 11 19:55:03 CST 2017, time=2017-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1491800, encodeId=1a7c1491800ff, content=<a href='/topic/show?id=b4f14442346' target=_blank style='color:#2F92EE;'>#头颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44423, encryptionId=b4f14442346, topicName=头颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b2d8903151, createdName=wshxjq, createdTime=Wed Oct 11 15:55:00 CST 2017, time=2017-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589734, encodeId=10cc1589e3415, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Wed Oct 11 15:55:00 CST 2017, time=2017-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=251690, encodeId=0cba25169057, content=你看实名认证了大家发言多么和谐, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLJUicgP739INvgkzTYsTUxNjAWx8qDjSzQJibnBH1tkJhsn5LdiaibBCG1dwJI6pLB0EHa3Qjx5ODh8A/0, createdBy=86d82167010, createdName=Anarkia, createdTime=Tue Oct 10 09:44:13 CST 2017, time=2017-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=251665, encodeId=6760251665fd, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Tue Oct 10 07:00:26 CST 2017, time=2017-10-10, status=1, ipAttribution=)]
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    2017-10-10 Anarkia

    你看实名认证了大家发言多么和谐

    0

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    2017-10-10 yfjms

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