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补充鱼油需谨防心房颤动

(2023-08-17 06:37:26) 下一个

一般都认为,鱼油可降低胆固醇,有益于预防心血管疾病,很多人因此都额外补充Omiga-3 鱼油胶囊。补充的剂量有日渐提高的趋势,以前是每日1克,现在每日2克,4克都很常见。

近年来临床发现,进补大剂量鱼油的人,常常发生心房颤动,引起医务界的警觉,因而触发了一系列研究,其中包括2018年的15000人的研究,2020年13000人的研究,和2021年8000人的研究。他们比较了进补鱼油和进食玉米油或其它矿物油后心房颤动的发生率,发现进食鱼油可使房颤的发生率增加。这一作用有剂量关系,在每日进补1克以上Omega-3 鱼油的人群中尤其明显,如每日进补4克鱼油,其发生率可高达69%。其中2020年的那项研究不得不因此中途叫停。这现象在65岁以上的老人和有糖尿病的人群中尤其明显。

鱼油导致房颤的机制尚不清楚。但科学界认为,在这个问题上,后果比机制更重要,所以需要引起重视,因为心房颤动是一严重的心功能异常。正常情况下,血液由心房入心室,再通过动脉运输到全身。心房颤动可导致血液在心脏内停滞时间延长,形成小的凝块,进入体循环后,可导致血管的堵塞。堵塞如发生在脑部,可导致致命的脑梗。

房颤可能是短暂性的,数天;或持续性的,数周;或永久性的。发生房颤时,你可能感到心脏扑动,心率不齐,疲劳眩晕,呼吸不畅,胸痛等等。

房颤有药可治,但不能忽视。如果你有以上的症状,搭脉发现脉搏异常,需及时就医,尤其对65岁以上的有高血压、糖尿病、和睡眠呼吸暂停症的老人。

鉴于以上的发现,我个人建议,补充鱼油的剂量,(指的是其中Omega3的含量, 即EPA和DHA的总量),不宜过高,应控制在每日0.5-1.0克之间。如有心率异常或心脏不适的现象,需引起警觉,不要忽视。

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瑞冬 回复 悄悄话 回复 'dong140' 的评论 : 治疗因人而异,包括控防血凝,控制心率,血压,安装起搏器,改变生活方式等等。具体选择看检查结果,且因人而定。你可和心脏专科医生商讨。下面是一篇关于治疗的文章,附上供参考。

The Best Atrial Fibrillation Treatment
By Staff WriterLast Updated June 24, 2020

If you’ve ever had the feeling of your heart fluttering or skipping beats, you may be suffering from atrial fibrillation (Afib). Though the feeling may be quite disconcerting, having Afib doesn’t necessarily mean you have a serious health condition.
Heart Fibrillation Symptoms
Some people have Afib and are unaware of it because they don’t have any symptoms of it. Others may experience one or more signs, as listed by Mayo Clinic. These include heart palpitations, dizziness, shortness of breath, confusion and chest pains. You should call your doctor immediately if you have any of these symptoms, though chest pain should warrant a trip to the hospital. Atrial fibrillation can take one of four forms: occasional, where the symptoms come and go with no particular rhyme or reason; persistent, where you require medical treatment to restore your heart’s regular rhythm; long-standing, which is continuous and lasts for at least 12 months; permanent, which often requires lifetime medications to control the heart’s rhythm.
Treating Atrial Fibrillation
Luckily, there are a variety of treatment options available for Afib. Your doctor will discuss them with you, and together you can decide what is the best course of action to treat your symptoms. Medications are effective in treating the effects of Afib and bringing your heart back to a normal rhythm. Blood thinners lower your risk of developing blood clots or having a stroke. There are drugs formulated to help slow a rapid heart rate so the heart can pump blood more effectively. Heart rhythm medications slow your heart’s electrical signals to bring it back to a normal sinus rhythm.
Pacemaker for Atrial Fibrillation
If medications alone do not treat your Afib, your doctor may try medical interventions. Two of the most popular choices are a pacemaker and an ablation. A pacemaker is a device placed in your chest that sends out pulses to help keep your heartbeat on track. An ablation is a procedure where tiny areas of heart muscle that set off the irregular rhythm are destroyed by radio waves or lasers.
Diet for Atrial Fibrillation
There are lifestyle changes that you can make to make your heart healthier. One is to re-haul your diet. You should work to eliminate fatty foods and incorporate heart-healthy, low-fat, low-salt foods. Aim for a plate chock full of vegetables, fruits and whole grains.
How You Can Prevent Atrial Fibrillation
Besides embracing a healthy diet, there are other things that you can do to lessen your chance of developing atrial fibrillation. Exercise regularly and drop excess pounds, if applicable. If you’re a smoker, stop immediately. Drink alcohol in moderation. Keep up with your annual doctor’s visits and tell him or her if your symptoms worsen.

瑞冬 回复 悄悄话 回复 'jelous' 的评论 : 英文名为Atrial Fibrillation. 我想,如果24 小时监测是阴性,只能说明目前没有房颤。因为房颤可以偶发,间断发作,和持续发作。
杨和柳 回复 悄悄话 谢谢,太及时了。
花似鹿葱 回复 悄悄话 谢谢救命提醒!
jelous 回复 悄悄话 房颤的英文叫什么?如果24小时检测器没监视出来就是没有么?其他症状都有
dong140 回复 悄悄话 房颤有药可治 -- 你知道药的名字吗?我岳母有这个毛病
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