邓熠:斑块逆转病例分享

2021-11-25 “心关注”公众号 “心关注”公众号

遵义医科大学附属医院心血管内科邓熠医师分享了1例超高危ASCVD患者的治疗策略。该患者为老年女性,主因胸痛、胸闷1月余,头晕10余天收入院。患者有高血压病史5年多,一直予以药物治疗,自诉血压控制可,住

遵义医科大学附属医院心血管内科邓熠医师分享了1例超高危ASCVD患者的治疗策略。该患者为老年女性,主因胸痛、胸闷1月余,头晕10余天收入院。患者有高血压病史5年多,一直予以药物治疗,自诉血压控制可,住院后详细检查,患者有严重血脂异常,伴颈动脉斑块,且有脑梗,PAD等高危因素,药物治疗予以依洛尤单抗强化降脂,治疗半年后血脂达标,LDL-C从6.29 mmol/L降至0.93 mmol/L,颈动脉斑块明显。特邀遵义医科大学附属医院心血管内科石蓓教授对病例进行点评,肯定了该病例应用PCSK9抑制剂依洛尤单抗的强化降脂策略,并结合循证证据及ESC指南进一步明确风险越高的患者强化降脂PCSK9抑制剂带来的获益越明显,依洛尤单抗治疗获益随着时间延长而不断增加,加用PCSK9抑制剂对改善患者临床症状和事件结局都将会有极大的益处。 病史资料 患者信息:63岁,女性。 主诉:胸痛、胸闷1月余,头晕10余天。 现病史:患者有高血压病史5年多,一直予以药物治疗,自诉血压控制可,具体药物不详;2年前曾于外院诊断脑梗塞,否认“糖尿病”病史;无吸烟史。 入院查体:T 36.2 ℃,P 78 次/分,R 20 次/

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1194349, encodeId=abe811943497e, content=非常有参考性, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ba1286668, createdName=huitailang, createdTime=Thu Feb 17 09:55:55 CST 2022, time=2022-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1076006, encodeId=dd8010e600684, content=想问下,我只看到了颈动脉明显,是少了两个字吗?是不是明显逆转这四个字?, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02565695686, createdName=sean1230, createdTime=Wed Dec 01 21:36:39 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074963, encodeId=bdfc10e496328, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b415591264, createdName=Weirdo0123, createdTime=Mon Nov 29 07:36:20 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330205, encodeId=fbf9133020591, content=<a href='/topic/show?id=a91c5e92328' target=_blank style='color:#2F92EE;'>#斑块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Sat Nov 27 13:19:21 CST 2021, time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074060, encodeId=946d10e4060fa, content=海市召开的第107场新冠肺炎疫情防控新闻, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Fri Nov 26 07:11:51 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074059, encodeId=025210e40593e, content=海市召开的第107场新冠肺炎疫情防控新闻, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Fri Nov 26 07:11:29 CST 2021, time=2021-11-26, status=1, ipAttribution=)]
    2022-02-17 huitailang

    非常有参考性

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1194349, encodeId=abe811943497e, content=非常有参考性, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ba1286668, createdName=huitailang, createdTime=Thu Feb 17 09:55:55 CST 2022, time=2022-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1076006, encodeId=dd8010e600684, content=想问下,我只看到了颈动脉明显,是少了两个字吗?是不是明显逆转这四个字?, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02565695686, createdName=sean1230, createdTime=Wed Dec 01 21:36:39 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074963, encodeId=bdfc10e496328, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b415591264, createdName=Weirdo0123, createdTime=Mon Nov 29 07:36:20 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330205, encodeId=fbf9133020591, content=<a href='/topic/show?id=a91c5e92328' target=_blank style='color:#2F92EE;'>#斑块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Sat Nov 27 13:19:21 CST 2021, time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074060, encodeId=946d10e4060fa, content=海市召开的第107场新冠肺炎疫情防控新闻, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Fri Nov 26 07:11:51 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074059, encodeId=025210e40593e, content=海市召开的第107场新冠肺炎疫情防控新闻, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Fri Nov 26 07:11:29 CST 2021, time=2021-11-26, status=1, ipAttribution=)]
    2021-12-01 sean1230

    想问下,我只看到了颈动脉明显,是少了两个字吗?是不是明显逆转这四个字?

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1194349, encodeId=abe811943497e, content=非常有参考性, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ba1286668, createdName=huitailang, createdTime=Thu Feb 17 09:55:55 CST 2022, time=2022-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1076006, encodeId=dd8010e600684, content=想问下,我只看到了颈动脉明显,是少了两个字吗?是不是明显逆转这四个字?, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02565695686, createdName=sean1230, createdTime=Wed Dec 01 21:36:39 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074963, encodeId=bdfc10e496328, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b415591264, createdName=Weirdo0123, createdTime=Mon Nov 29 07:36:20 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330205, encodeId=fbf9133020591, content=<a href='/topic/show?id=a91c5e92328' target=_blank style='color:#2F92EE;'>#斑块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Sat Nov 27 13:19:21 CST 2021, time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074060, encodeId=946d10e4060fa, content=海市召开的第107场新冠肺炎疫情防控新闻, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Fri Nov 26 07:11:51 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074059, encodeId=025210e40593e, content=海市召开的第107场新冠肺炎疫情防控新闻, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Fri Nov 26 07:11:29 CST 2021, time=2021-11-26, status=1, ipAttribution=)]
    2021-11-29 Weirdo0123

    学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1194349, encodeId=abe811943497e, content=非常有参考性, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ba1286668, createdName=huitailang, createdTime=Thu Feb 17 09:55:55 CST 2022, time=2022-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1076006, encodeId=dd8010e600684, content=想问下,我只看到了颈动脉明显,是少了两个字吗?是不是明显逆转这四个字?, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02565695686, createdName=sean1230, createdTime=Wed Dec 01 21:36:39 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074963, encodeId=bdfc10e496328, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b415591264, createdName=Weirdo0123, createdTime=Mon Nov 29 07:36:20 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330205, encodeId=fbf9133020591, content=<a href='/topic/show?id=a91c5e92328' target=_blank style='color:#2F92EE;'>#斑块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Sat Nov 27 13:19:21 CST 2021, time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074060, encodeId=946d10e4060fa, content=海市召开的第107场新冠肺炎疫情防控新闻, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Fri Nov 26 07:11:51 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074059, encodeId=025210e40593e, content=海市召开的第107场新冠肺炎疫情防控新闻, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Fri Nov 26 07:11:29 CST 2021, time=2021-11-26, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1194349, encodeId=abe811943497e, content=非常有参考性, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ba1286668, createdName=huitailang, createdTime=Thu Feb 17 09:55:55 CST 2022, time=2022-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1076006, encodeId=dd8010e600684, content=想问下,我只看到了颈动脉明显,是少了两个字吗?是不是明显逆转这四个字?, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02565695686, createdName=sean1230, createdTime=Wed Dec 01 21:36:39 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074963, encodeId=bdfc10e496328, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b415591264, createdName=Weirdo0123, createdTime=Mon Nov 29 07:36:20 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330205, encodeId=fbf9133020591, content=<a href='/topic/show?id=a91c5e92328' target=_blank style='color:#2F92EE;'>#斑块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Sat Nov 27 13:19:21 CST 2021, time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074060, encodeId=946d10e4060fa, content=海市召开的第107场新冠肺炎疫情防控新闻, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Fri Nov 26 07:11:51 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074059, encodeId=025210e40593e, content=海市召开的第107场新冠肺炎疫情防控新闻, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Fri Nov 26 07:11:29 CST 2021, time=2021-11-26, status=1, ipAttribution=)]
    2021-11-26 查查佳佳

    海市召开的第107场新冠肺炎疫情防控新闻

    0

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    2021-11-26 查查佳佳

    海市召开的第107场新冠肺炎疫情防控新闻

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