从一好友痛失爱妻于夹层动脉瘤, 浅谈慢/恶病的早期诊断

近日得知,我一好友和同事的妻子, 60多岁, 毫无预兆地突然死于髂主动脉夹层瘤(Dissecting iliac artery aneurysm)。不久之前,我的一位医学院的才50多岁的年轻医生校友也突发夹层动脉瘤,造成严重且持久的残疾。

有问题联系成博士, 请扫描此二维码。由于技术原因,成博士不回答公众号内提问。

在我40年的医疗生涯中,我也通过听诊遇到并诊断过一些腹部动脉瘤患者。但不幸的是,许多此类动脉瘤的临床病例直到太晚才被诊断出来。上述案例就是这样的例子。

大多数(即使不是全部)慢性疾病和衰老过程,包括动脉瘤(PMID:27779166,27325965,29224120),都以增加的氧化应激(炎症)为特征。 hsCRP是一种简单的实验室血液检测,是氧化应激的敏感标志物。 年度hsCRP和其他筛选检测(见下)对于疾病的早期发现具有重要价值。所有慢性病都会在很长一段时间内发展和演变。患者直到很晚才会感觉到任何症状,往往为时已晚。如夹层动脉瘤,患者在致命性急症出现之前可能没有任何迹象或症状。由训练有素的提供者正确解释的升高的hsCRP可以在早期阶段揭示许多疾病。

我强烈建议读者找一位接受过抗衰老(功能性或综合性)药物培训的优秀医生,并要求每年进行一次这些检查。我们在Cheng综合健康中心拥有专门从事这一领域的医疗服务提供者。

为什么常规体检查不出癌症,因为常规体检查的项目都比较晚(如B超,心电图)。等到这些检查发现问题,基本上都来不及了。而真正的好的体检是查早期,亚健康期,疾病还在可逆期。国内花费昂贵,动则几万元的体检报告,在我看来,意义不大。真正要查的,都未查。

中老年人(45岁以上)抗衰老/功能医学筛选检查

1.  血液: 血常规,血生化(含空腹血糖,常规肝肾功能,血脂),  维生素B12, 叶酸,维生素D-25OH, 甲状腺功能(T3, T4, TSH, rT3, 甲状腺自身抗体),空腹胰岛素, HBA1C,运铁蛋白(ferritin),C反应蛋白(hs-CRP),同型半胱氨酸(homocysteine),脂蛋白a(Lp(a)), 尿酸,PSA (男性);

2. 24小时考的松(Cortisol) (6-8 am; 11am-12pm; 5-6pm; 10pm-12am); DHEAs, 睾丸酮(Testosterone), 雌激素(E1, E2, E3), 孕激素(Progesterone) , FSH, LH;

3. 骨密度检查;

4. 冠状动脉钙沉积指数(Coronary Artery Calcium score, CAC);

5. 重金属及毒性元素检测。

    成长医学博士, 生物化学/分子生物学博士是美国成氏综合健康中心主任,美国抗衰老暨再生医学科学院研究员,卡塔尔王国女皇医院抗衰老/功能医学顾问。旅美30余年的成博士毕业于上海医科大学,曾任上海中山医院, 美国国立卫生研究院癌症研究所及美国陆军医院(MACH)主任医师。有40余年从医经验的成博士经常应邀作讲座(美国, 德国, 荷兰, 卡他尔, 上海, 北京, 深圳及国内其他地区)。成博士近年来也通过书籍(《癌症是一代謝病》《隐形杀手—-补钙剂》《万应灵丹,关于VC的百科全书》)等, 将国际上最新研究介绍到中国。
成博士结合40年西医及10余年抗衰老/功能医学经验,尤其擅长以下领域:
1. 慢病管理,尤其是高血压,糖尿病,高血脂, 痛风, 动脉硬化(冠心病), 骨质疏松;
2. 牛皮癣, 湿疹, 斑秃,白癫风等各种自身免疫性皮肤病, 桥本氏甲状腺炎, 炎症性肠病(Crohn‘s病, 溃疡性结肠炎),红斑狼疮, 类风湿等自身免疫病;
3. 癌症代谢疗法;
4. 中老年人保健,抗衰老/功能医学体检;
5. 减肥;
6. 各种疑难病症。

I am saddened by the news that one my dear friends and colleagues suddenly lost his wife, in her 60s, to a dissecting arterial aneurysm. Sometime ago, one of my medical school alumni also suffered from a dissecting arterial aneurysm, causing significant and long lasting disability at a relatively young age of 50s.

In my 4 decades of medical career, I also encountered and diagnosed some abdominal arterial aneurysm patients by auscultation.  But unfortunately, many clinical cases of such aneurysm were not diagnosed until too late. The cases mentioned above are such illustrations.

Most if not all chronic disease and aging process, including dissecting arterial aneurysm (PMID: 27779166, 27325965, 29224120), are marked by an increased oxidative stress (inflammation).  hsCRP, a simple lab blood test, is a sensitive marker for oxidative stress. Annual testing of hsCRP and other tests (below) are of great value in detection of early diseases.  All chronic diseases develop and evolve over a long period of time. A patient will not feel anything until a very late stage, often too late.  In the case of dissecting aneurysm, a patient may not have any signs or symptoms until an emergency presents itself.  An elevated hsCRP, properly interpreted by a trained provider, can reveal many diseases at the very early stages.

I strongly advise readers to find a good doctor with proper training in anti-aging (functional or integrative) medicine and ask for these tests to be done annually.  We, at the Cheng Integrative Health Center, have healthcare providers specializing in this field.

Anti-Aging Initial Screening Lab Tests

  • For men: B12, Cortisol, DHEA-s, E1, E2, Folate, Free T, Total T, FSH, LH, Progesterone, PSA, SHBG, IGF-1, Free T3/T4, TSH, Vitamin D 25OH, CBC with diff, CMP, CRP-HS, Ferritin, HgbA1C, Homocysteine, (fasting) insulin, lipid panel, Lp(a) and uric acid.

  • For women: B12, Cortisol, DHEA-s, E1, E2, E3, Folate, Free T, Total T, FSH, LH, Progesterone, SHBG, IGF-1, Free T3/T4, TSH, Vitamin D 25OH, CBC with diff, CMP, CRP-HS, Ferritin, HgbA1C, Homocysteine, (fasting) insulin, lipid panel, Lp(a) and uric acid.

  • Bone density scan

  • Coronary Artery Calcium Score (CAC)

  • Toxic metals testing (urine)

Richard Z. Cheng, M.D., Ph.D.

Cheng Integrative Health Center

Columbia SC USA

www.DrWLC.com