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[飲食養生] 糖尿病患者心衰風險這么高!留意6個早期信號

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發表于 2019-2-7 05:08:55 | 只看該作者 回帖獎勵 |倒序瀏覽 |閱讀模式
糖尿病與心衰雖并非一般的合并癥,而是相互促進和相互惡化的關系。

來自美國的Framingham心臟研究表明:罹患糖尿病能使男性和女性發生心力衰竭的風險分別增加2.4倍和5倍,而且這一增加與高血壓或冠脈疾病無關。

發表于2015年的《糖代謝異常與動脈粥樣硬化性心血管疾病臨床診斷和治療指南》中就強調“心衰是降糖藥物心血管安全性的重要考慮因素之一”。

糖尿病患者的心衰風險之所以這么高,首先是因為糖尿病患者更容易發生動脈粥樣硬化,伴隨彌漫性的嚴重動脈血管狹窄,這將會直接導致心肌供血障礙——缺血性心肌病,最終誘發嚴重心衰;另外,即使糖尿病患者的冠脈病變輕微,長期高血糖也會帶來自主神經病變、微循環功能障礙及代謝和能量的改變。

應對糖尿病合并心衰,首先就得在平時做好預防工作,積極改善生活習慣,降糖降脂,控制體重。

其次,也應該留意“隱藏”的心衰。比如當糖尿病患者出現體力差、氣短、夜間躺下睡覺經常被憋醒,以及手腳冰涼、全身性水腫、突發的神志淡漠或人格改變等,就要懷疑可能是心衰了,就應當盡早去醫院檢查確診,比如做胸片、超聲心動圖、血腦鈉素水平等。

對于那些已經存在冠脈狹窄的糖尿病患者,即使沒有心絞痛的癥狀,也建議通過冠脈造影來盡早處理狹窄;如果糖尿病合并心衰的患者病情穩定,還應通過冠脈造影來明確缺血性心肌病的存在與否。

雖然我們說心衰是心臟疾病的終末階段,但并不意味著短時間內就會危及生命,如果能夠早診早治、選擇合適的降糖藥和抗心衰藥,并且注重改善生活習慣,按時監測檢查,一樣能夠延緩病情和提高生活質量。
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