冠心病

冠心病

冠心病全称冠状动脉粥样硬化性冠心病(CDH),是心脏冠状动脉壁有粥样硬化斑块形成,使动脉管壁狭窄、闭锁,影响循环血流导致心肌缺血的疾病。

妇女在停经前,冠心病的发生率低於男性,男性在45岁时死於冠心病者较女性高5—6倍,而停经後,妇女的发病率快速增加,在60岁时,死亡率男女相等。早期停经者(一特别双卵巢切除後) 冠心病的危险性增加两倍。近20年内,许多研究发现,雌激素补充治疗可以降低冠心病的危险性约40%,降低中风约20%。以上揭示体内雌激素保护妇女冤於患冠心病。

雌激素降低致使冠心病增高的原因是多方面的:

使血脂代谢改变。有关研究发现雌激素降低使引起冠心病的血总胆固醇、甘油三酯及低密度脂蛋白胆固醇升高,而对心血管具有保护作用的高密度脂蛋白胆固醇降低。

糖代谢改变。糖尿病发生率增高,加重心血管粥样硬化病理改变。

凝血功能改变。有研究显示停经後妇女血液处於高凝状态,血栓形成危险增加。

动脉功能发生改变等。

因此,预防停经期冠心病应注意:对於45岁前接受妇科手术的病人只要病情允许应尽量保留卵巢;合理安排作息,注意劳逸结合;适当限制脂类和糖类食物,随著年龄的增长,基础代谢逐渐下降,热量需要减少,所以膳食必须合理调整。否则摄入热能过多,势必导致肥眫和高血脂而诱发冠心病。若以20—39岁的热能摄入为标准,则40—49岁应减少5%,50—59岁应减少10%。

另外,碳水化合物应占每天总热量的55%—60%,以谷类为主,限制甜食;脂肪摄入应控制在30%以下,并以植物油为主,应有一定数量的瘦肉、鱼类和蛋类等动物蛋白,适当补充豆制品,多食新鲜蔬菜和瓜果;坚持适度的体育锻练,运动不仅能增加热能消耗,促进机体代谢、增强体质,且能降低血胆固醇和甘油三酯,提高血液中高密度脂蛋白的含量,从而增强机体防御动脉粥样硬化的能力。

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