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認識三高疾病系列 – 入門篇
什麼是三高 ?
什麼是三高 ?
三高就是
高血壓、高血糖、高血脂!
這五項死亡疾病的
危險因子就是和三高
有相當密切的關係。
國人罹患三高情況
三高就是
高血壓、高血糖、高血脂!
Hypertension
什麼是血壓 (Blood pressure)?
所謂血壓有 2 種:
心臟收縮,將血液經由大動脈送往全身時,
所產生的壓力,稱為收縮壓 ( 最高血壓 ) 。
所謂血壓有 2 種:
收縮的心臟放鬆,身體的血液回流到心臟時的壓力,
稱為舒張壓 ( 最低血壓 ) 。
血壓多少才算高 ?
血壓分類
收縮壓 ( 毫米汞
柱 )
舒壓 ( 毫米汞柱 )
理想血壓 < 120 毫米汞柱 及< 80 毫米汞柱
正常血壓 < 130 毫米汞柱 及< 85 毫米汞柱
正常但偏高
130-139 毫米汞
柱
或 85-89 毫米汞柱
高血壓
第一期
140-159 毫米汞
柱
或 90-99 毫米汞柱
第二期
160-179 毫米汞
柱
或 100-109 毫米汞
柱
成年人之血壓分期
三高就是
高血壓、高血糖、高血脂!
Hyperlipidemia
什麼是血脂 ?
血液中所含脂肪簡稱血脂。
血脂
1. 總膽固醇
2. 三酸甘油酯
3. 磷脂
4. 游離脂肪酸
臨床上一般只測定總膽固醇和三酸甘油酯。
當血中的總膽固醇過高、
三酸甘油酯濃度偏高、
高密度脂蛋白膽固醇濃度偏低以及
低密度脂蛋白膽固醇濃度偏高等,
任一異常或多種異常情形均可稱為高血脂或血脂異常。
血液中的脂肪濃度越來越高,將加速動脈硬化,
可能導致中風、心絞痛、心肌梗塞。血壓過高者將伴
隨著形成脂肪肝,長期演變成肝硬化。
血脂多少才算高 ?
中華民國血脂異常分類之建議
分類 血脂濃度 mg/dl
高膽固醇血症 總膽固醇( TC )≧ 200
混和型高脂血症 總膽固醇( TC )≧ 200 且
三酸甘油酯( TG )≧
200
高三酸甘油酯血
症
三酸甘油酯( TG )≧ 200 且合
併 TC/HDL-C≧5 或
高密度脂蛋白膽固醇< 40
三高就是
高血壓、高血糖、高血脂!
Hyperglycemia
什麼是糖尿病 ?
糖尿病是因為無法產生足夠的 胰島素,
使葡萄糖無法進入細胞,血糖濃度就會升高。
血液中葡萄糖含量上升到超過腎臟所能回收的極限
時,
葡萄糖便會從尿液中 " 漏 " 出,所以稱之為糖尿病
。
糖尿病的典型症狀
血糖多少算正常 ?
診斷糖尿病以測定血糖為主。
正常 ( 無懷孕 ) 成人:
空腹 血漿中血糖 <115 mg/dl
飯後兩小時 血漿中血糖 <140 mg/dl
若有下列情況,也可診斷為糖尿病:
空腹靜脈血糖有兩次 是 140mg/dl 或以上。
隨時測得的血糖 ( 無論空腹與否的所謂隨機血糖 )
是
200mg/dl 或以上,同時合併出現糖尿病典型症
狀 ( 包括多喝、多尿、多吃、體重下降等症狀 ) 。
糖尿病症狀及併發症
降三高刻不容緩
三高對人體器官的影響
頭部 ( 腦、眼睛 )
腦中風、腦出血、
視網膜病變、
青光眼、白內障
三高對人體器官的影響
心臟、血管
心衰竭、心肌梗塞、
血管動脈瘤、血管栓
塞
三高對人體器官的影響
腎臟
腎臟病變 ( 尿毒
症 ) 、
腎性高血壓
三高對人體器官的影響
泌尿系統
泌尿道感染
三高對人體器官的影響
足部、神經
糖尿病足、周邊神經病變、
周邊動脈血管阻塞
中華民國糖尿病學會秘書
長
郭清輝醫師表示:
只要有高血壓、高血脂或高血糖中的任一高,
就必須同時留意罹患其他二高的可能性,
因為三高之間的關聯猶如三胞胎密切相關。
預防及保健之道
1. 飲食原則
2. 日常保健
3. 藥物治療
預防及保健之道
1. 飲食原則
1. 限制含鈉量高的食物及調味品。
2. 烹調選植物油,限制膽固醇含量高的食物。
3. 選擇新鮮食物避醃製類。
4. 均衡飲食,少用刺激性調味品。
5. 遵循與營養師共同協商的飲食計劃,
養成定時定量的飲食習慣。
6. 常選用富含纖維質之食物。
7. 少吃油炸、油煎、油酥和油炒的食物,
以及豬皮、雞皮、鴨皮、魚皮等含油脂高的食
物
預防及保健之道
2. 日常保健
1. 維持理想體重。
體 重 指 標 (BMI) = 體 重 (kg)/ 身高 (m)2
建 議 理 想 指 標 ( 亞 洲 成 人 標 準 ) :
理 想 18.5 - 22.9 (kg/m2
)
超 重 23 (kg/m2
)
肥 胖 > 25 (kg/m2
)
2. 避免抽煙、喝酒。
3. 運動。
4. 放鬆心情。
5. 定期檢查。
預防及保健之道
3. 藥物治療
治療三高的藥物
降血壓藥物
ISMO-20 、 Amodipine 、
Inderal 、 cozaar Tamlosin 、
fosinopril
降血脂藥物 Rosuvastatin 、 ATORVASTATIN
降血糖藥物 ACARBOSE 、 GLUCOPHAGE
2011 年
什麼是代謝症候群 ?
代謝症侯群是現代人的健康大敵,
可怕的是它卻沒有明顯症狀!
腹部肥胖和血壓高、飯前血糖高、三酸甘油酯高、
高密度膽固醇偏低等,並列為代謝症侯群的診斷標準
,
民眾若是上述五項有三項或超過三項異常,
即屬代謝症侯群。
代謝症候群患者未來罹患
糖尿病、高血壓、高血脂症、心臟病及腦中風的機率
為
無代謝症候群者的 6 、 4 、 3 、 2 倍 !
代謝症候群患者
罹患三高慢性病的機率遠超過一般人
控制血糖、血壓及血脂的數值是
預防疾病形成的重要原因
代謝症候群治療目標
項目 目標
體重 控制在理想範圍
腰圍 男性 <90 公分,女性 <80 公分
血壓 130/80 毫米汞柱
血脂肪
總膽固醇 <200 mg/dl
三酸甘油脂 <150 mg/dl
LDL <150 mg/dl
HDL >45 mg/dl
血糖值 糖化血色素 (HbA1c) 值 < 6.5
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Three-Hypers Series - Introduction

Editor's Notes

  1. 血糖blood sugar 血脂blood lipid 血壓blood pressure 三高: 高血糖hyperglycemia 高血脂hyperlipidemia 高血壓hypertension  
  2. three-hypers 三高,就是指高血壓,高血脂,高血糖!這類人統稱“三高”人群。英文叫3High:Hypertension, High blood cholesterol, High blood sugar,簡稱3H 。
  3. 高血糖hyperglycemia 高血脂hyperlipidemia 高血壓hypertension
  4. 高血糖hyperglycemia 高血脂hyperlipidemia 高血壓hypertension
  5. 高血糖hyperglycemia 高血脂hyperlipidemia 高血壓hypertension
  6. 體 重 指 標 (BMI) =體 重 (kg)/ 身高 (m)2  建 議 理 想 指 標 (亞 洲 成 人 標 準) 理 想:18.5 - 22.9 (kg/m2)、超 重: 23 (kg/m2) 、 肥 胖: &amp;gt; 25 (kg/m2)
  7. 代謝症候群相關治療有下列目標: 體重:控制在理想範圍,男生腰圍