动脉钙化、动脉硬化、动脉粥样硬化有什么区别?哪个更可怕?看完这篇就明白了

2021-11-28 药师华子 药师华子

我们经常会谈到动脉钙化、动脉硬化、动脉粥样硬化,这三者有什么区别吗?哪个危险性更大呢?

我们经常会谈到动脉钙化、动脉硬化、动脉粥样硬化,这三者有什么区别吗?哪个危险性更大呢?

概括来说,动脉粥样硬化的危险性要大于动脉硬化与动脉钙化,所带来的不良后果更多。而动脉钙化相对来说是一种比较稳定的状态,危险性比较小。

01 动脉硬化与年龄、血压、吸烟等相关

人体的动脉有一定的弹性,但随着年龄的增加,动脉的弹性会逐渐减弱,可能造成动脉内膜增厚、管径变小,血液流动的阻力增加,导致血压升高。

当血压升高后,又会加重动脉硬化的程度,两者形成恶性循环。

动脉硬化的血压特点是高压升高,低压不变或降低,脉压增大,是老年性高血压的主要特征。

除了高血压,吸烟也会造成动脉硬化进程加速。

有些四五十岁的人,如果高血压控制不佳或有吸烟的习惯,也可能出现严重的动脉硬化。

所以控制血压和戒烟能够在一定程度延缓动脉硬化的进程。

02 动脉粥样硬化的危险性大

临床有的患者会被检查出动脉粥样硬化,动脉粥样硬化危险性大,是脑梗死、心肌梗死等心脑血管疾病的重要影响因素。

动脉粥样硬化发生的主要过程是动脉内膜受损后,血液中的胆固醇进入动脉内膜中,被巨噬细胞吞噬之后形成泡沫细胞,构成了硬化的斑块。

图片

如果把斑块剖开,就会看到许多淡黄色小颗粒状的泡沫细胞,有点像“小米粥”,所以被称为粥样硬化。

不稳定的粥样硬化斑块表面容易发生破溃,诱使血小板聚集形成血栓,引起疾病。

所以粥样硬化斑块需要用他汀类药物稳定斑块,以及用抗血小板药物预防血栓形成。

03 动脉钙化是血管的“疤痕”

有些人在做动脉检查的时候,会发现钙化点,也就是所说的动脉钙化。

这种钙化,是动脉损伤自我修复之后,组织细胞中钙离子的沉积。

也可以理解为动脉钙化是动脉受损修复之后形成的“疤痕”。

图片

形成钙化后,通常代表损伤局部的炎症反应已经稳定。

比如肺结核形成的钙化灶,或者男性前列腺中的钙化点等可能是炎症痊愈之后残留的痕迹,这是一种相对稳定的状态。

临床上常用钙化积分有效评价心血管事件发生率,将动脉钙化作为一项危险因素看待。

但是,现在有一些研究观点认为,如果是在动脉粥样硬化的基础上发生了动脉钙化,可能在一定程度上对动脉本身会产生保护作用,钙化斑块破溃的可能性会降低。

所以动脉钙化对于心血管疾病的影响需要辩证看待。

04 做好心脑血管疾病的预防

其实我们很难完全避免动脉硬化、钙化、粥样硬化的发生,但是现在可以通过使用药物,控制血压、血脂、血糖,戒烟限酒等来延缓疾病进展。

对“三高”的管控,要做到以下标准:

控制“三高”
01 血压

将血压控制在140/90 mmHg以下,条件允许时控制在130/80 mmHg以下。

02 血脂

将血脂中的低密度脂蛋白胆固醇控制在2.6 mmol/L以下,条件允许时达到1.8 mmol/L以下;甘油三酯控制在2.26 mmol/L以下。

03 血糖

将空腹血糖降到7 mmol/L以下,餐后2小时血糖值控制在11.1 mmol/L以下,糖化血红蛋白低于6.5%。

小  结

其实动脉粥样硬化是动脉硬化中重要并且危害比较大的一种,在动脉硬化、动脉钙化、动脉粥样硬化三者中,动脉粥样硬化的危险性更大,需要积极控制。而动脉钙化对健康的影响是双向的,需要辨证看待。

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    2022-03-14 云舒

    谢谢🙏

    0

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    2021-11-29 curry1989

    学习了

    0

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Int J Biol Macromol:蛹虫草多糖CM1抗动脉粥样硬化机制的综合生物信息学分析

蛹虫草多糖CM1调控脂质代谢、炎症反应和氧化还原酶多种途径,改善动脉粥样硬化,有助于解释蛹虫草子实体多糖的抗动脉粥样硬化作用等生物活性。

Circulation:低一点,好一点丨FOURIER探索性分析: LDL-C降低至1 mmol/L(40 mg/dl)以下仍有心血管获益,且安全性良好

低密度脂蛋白(LDL) 是动脉粥样硬化性心血管疾病(ASCVD)的明确致病因素。LDL在动脉壁内修饰、蓄积,导致动脉粥样硬化斑块的形成和进展,斑块侵蚀、破裂进一步引起心血管事件的发生

心电图or颅脑MRA?更能找出预后不良的癌症合并卒中患者?

PLOS ONE:颅内动脉粥样硬化和心房颤动对活动性癌症患者缺血性中风的预后的影响