颈动脉斑块是否需要服用阿司匹林?

2017-09-23 郭艺芳 郭艺芳心前沿

随着人们保健意识的增强,健康查体的人数越来越多。很多人无明显临床症状,但超声检查却发现有颈动脉斑块,这些人需要应用阿司匹林吗?这个问题要区别对待。

随着人们保健意识的增强,健康查体的人数越来越多。很多人无明显临床症状,但超声检查却发现有颈动脉斑块,这些人需要应用阿司匹林吗?这个问题要区别对待。

若患者存在明显的颈动脉狭窄(狭窄≥50%),应纳入动脉粥样硬化性心血管病的管理范畴(即等同于冠心病或缺血性卒中),应该服用阿司匹林进行二级预防

若患者只是存在一处或多处斑块,但未导致管腔狭窄,或虽有狭窄但狭窄程度<50%,则需要结合患者所存在的其他心血管危险因素确定是否需要服用阿司匹林进行一级预防。换言之,未导致动脉管腔明显狭窄的斑块本身并不是应用阿司匹林的指征。对于此类患者,若具有以下≥3种危险因素,则应服用阿司匹林:

1)男性≥50岁或女性绝经期后;
2)得到初步控制的高血压高血压患者经治疗后血压<150/90 mmHg);
3)糖尿病
4)高胆固醇血症;
5)肥胖(体质量指数≥28);
6)早发心血管病家族史(父母一方或双方男性<55岁,女性<65岁发病);
7)吸烟。


此外,高血压合并慢性肾病者也是应用阿司匹林的适应证。

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    2017-09-23 戒馋,懒,贪

    谢谢分享

    0

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