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1. \u9996\u5148\u65e5\u5e38\u6c92\u6709\u660e\u986f\u7684\u5fc3\u81df\u75c5\u75c7\u72c0\uff0c\u505a\u904b\u52d5\u6642\u6700\u597d\u6709\u4f34\u540c\u884c\uff0c\u9047\u6709\u7a81\u767c\u4e8b\u4ef6\u6642\u4e5f\u6709\u4eba\u4ee3\u6c42\u6551\u3002<\/p>\n

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https:\/\/health2.mingpao.com\/ftp\/Health2\/20170814\/news\/_14yd101.jpg\u5fc3\u81df\u75c5\u767c\u2014\u2014\u9177\u71b1\u4e0b\u4f5c\u6236\u5916\u904b\u52d5\uff0c\u907f\u514d\u5f37\u5ea6\u592a\u9ad8\uff0c\u5426\u5247\u53ef\u80fd\u5f15\u767c\u5fc3\u81df\u75c5\u3002\uff08Toms93@iStockphoto\uff09\uff08\u8a2d\u8a08\u5716\u7247\uff0c\u76f8\u4e2d\u6a21\u7279\u5152\u8207\u672c\u6587\u63d0\u53ca\u75be\u75c5\u7121\u95dc\uff09;https:\/\/health2.mingpao.com\/ftp\/Health2\/20170814\/news\/_14YD005_.jpg\u674e\u6a39\u5805\uff08\u5716\uff1a\u8a31\u671d\u8335\uff09;<\/inline><\/p>\n","protected":false},"excerpt":{"rendered":"

【明報專訊】上周連續多日發出酷熱警告，出街走一轉已經汗流浹背，忍不住高呼「熱死人」；但原來炎熱天氣真的會增加死亡機率，中大及理大研究團隊最新發現，持續高溫會推高死亡風險，包括心血管疾病患者。心臟科專科醫生亦指出，戶外運動會增加心肌梗塞的風險。<\/p>\n

其實酷熱天氣或高溫環境，如何影響心臟功能？心臟病人在夏天，難道要日日留在家？<\/p>\n

中大及理大研究團隊的研究指出，連續5個熱夜（晚上逾28℃）額外總死亡率最高達7.99%，心血管及呼吸系統疾病的額外死亡率亦達7.74%及8.13%；連續3個熱日（日間最少1小時達33℃）的整體及心血管病額外死亡率則升約8%。<\/p>\n

香港心臟專科學院院長李樹堅指出，天氣冷熱與心肌梗塞（心臟病發）有一定關係，有冠心病或慢性心臟衰竭等問題的患者，就算本身血管有些少閉塞或泵血功能稍弱的情况，只要處於穩定狀態下也可應付日常生活；不過一旦受外間刺激，心臟功能便受影響，受損程度視乎個人的心臟健康。<\/p>\n

烈日下運動必須減強度<\/p>\n

如果病人本身的心臟功能很弱，在天熱時作靜態活動已可以導致心肌梗塞甚至死亡，但這類個案較少在港出現，反而在歐美較常見；香港較多的情况是在天熱下做運動，引發出隱性心肌梗塞。這類患者的心臟功能未必好差，只是在高溫加上運動才爆發。一個三十出頭的男子，本身是行山健將，體能良好兼身形標準，有次在酷熱警告下行山，突然感到心口劇痛，需要由直升機送院，原來他有隱性冠心病，要接受通波仔手術。「做適量運動有益心臟健康，但在天熱環境下所進行的強度，最好較平日少，避免心臟負荷過重。」<\/p>\n

一熱一冷雙重刺激 泡凍水攞命<\/p>\n

除了留意運動強度，亦要避免一冷一熱的環境。早前台灣有個七十歲老翁，於酷熱天氣下在溪澗泡水消暑，引發心臟病，送院不治。李樹堅解釋﹕「天氣熱時體溫上升，人體需要靠出汗散熱外，皮膚表面的微絲血管亦會擴張協助散熱。當全身有不少血管擴張時，會增加血液流量，從而提升整體血液循環，令心跳加快，加重心臟工作量。」天熱已為心臟病人帶來第一重刺激，如在高溫跳入冷水中，便製造出第二重刺激。「因本身血管已經擴張了，溫度一跌，血管會收縮，血壓又再急升，再次增加心臟負荷，自然促使了心肌梗塞的風險。」<\/p>\n

不過，並非每次心肌梗塞也會導致死亡。平日心臟是靠電流信息來控制，作出有規律的跳動，當心臟梗塞時未能及時打通血管，心臟肌肉細胞陸續缺氧死亡，垂死的細胞會發出干擾電流，擾亂心跳，出現心室顫動，不能正常有規律地跳動，有機會猝死。「心臟細胞由缺氧至出現干擾性電流，可以是幾分鐘至數小時不等，所以病發後，愈早醫治，得救機會愈大，首十多小時是關鍵，而且病發情况無法預計，可以急速惡化。不過就算心肌梗塞經治療後，心臟功能亦會受損，愈多細胞死亡，心臟功能愈差，增加心衰竭機率，長遠而言會影響壽命。」<\/p>\n

避免飲酒精或咖啡因飲料<\/p>\n

天熱時經常汗流浹背，如身體水分不夠會影響血液循環，減少血液總量，如全身有5公升血，但脫水時只得4.5公升，心臟要落力地泵多些血補充。此外，其時的血液濃度高了，變得較「杰身」，血小板也較活躍，增加血塊凝結及閉塞血管的風險，因此心臟病患者要定時補充水分，但避免飲用酒精或咖啡因等利尿飲料，增加水分流失。<\/p>\n

然而飲水過多同樣會出事。心臟衰竭患者如吸收太多水分，血量多了，四肢的血液流回心臟較慢，會引致腳腫，未必有即時危險；但如果肺部血液流回心臟太慢，可導致肺水腫，影響呼吸，情况較危險。「嚴重的心臟衰竭患者，每日限飲1至1.5公升水，本身可能獲處方利尿劑，在熱天時會增加脫水機率。但大量飲水又增加心臟工作量，所以在這情况較難取得平衡，要小心處理。」<\/p>\n

嚴重患者最好每日量度體重，如果體重明顯增加，腳踭位有些腫，就可能水分多了，要注重飲食，避免食太多鹽及飲水太多。不過，如患者覺得口渴時，始終也要補充適量水分，因為腦部感應到渴時，水分已不足，尤其是長者的感應較慢，口渴時可能已缺水了一段時間。<\/p>\n

■安心運動四招<\/p>\n

運動有助強化心臟功能，如果本身有心臟病時作戶外活動，最好遵守香港心臟專科學院院長李樹堅建議以下四點守則﹕<\/p>\n

1. 首先日常沒有明顯的心臟病症狀，做運動時最好有伴同行，遇有突發事件時也有人代求救。<\/p>\n

2. 別作難度太高的運動，如平日行十公里路程，天熱時宜減短路程。<\/p>\n

3. 作分段式休息，別一鼓作氣令體能去得太盡。<\/p>\n

4. 傷風感冒時，別作戶外運動，增加心臟負荷外，因食藥影響排汗散熱，增加中暑風險。<\/p>\n

■知多啲<\/p>\n

分清中暑／心肌梗塞 急救法相反<\/p>\n

近日不時有行山者於途中昏迷，中暑和心臟病發的症狀有分別嗎？李樹堅教路，中暑前出現的熱衰竭，患者會頭暈出汗，手腳冰冷及面青唇白，血壓下跌，情况沒改善便進一步變成中暑，出現昏迷抽筋，失去意識，體溫可達40℃，皮膚滾熱。<\/p>\n

至於心肌梗塞，未必會即時暈倒，一般先是心口痛，之後出現氣喘，最嚴重時會失去知覺，心臟停頓猝死。「心肌梗塞時未必一定按程序出現，可以是心口痛無氣喘，但不代表不會猝死，或者有嚴重的氣喘但又未必會死亡，病發過程難以預測，這刻可以跟人聊天，下一刻可能暈倒。」<\/p>\n

大家見到中暑患者時，應送他們陰涼地方降溫，然而不少人遇到別人暈倒時，自然想扶對方坐起來，但事實上暈倒是因血壓低，血流不到上腦，因此應讓患者平躺及墊高腳，令血液返回腦部，別勉強患者坐起來，否則血更流不到上腦。處理心肌梗塞者則剛剛相反，要找個舒適位置坐起來，令呼吸回復正常，別要他們平躺，否則會加重呼吸不順。<\/p>\n

無論是中暑或心肌梗塞，都應要報警求助，及早送患者求醫。<\/p>\n

■及早預防<\/p>\n

35歲起要驗心<\/p>\n

現時心臟病患者有年輕趨勢，二三十歲已有問題，撇除先天因素，大多是因三高問題，尤其是膽固醇及食煙等問題。有個三十多歲的文職男子，向來喜歡大魚大肉，尤其是肥牛火鍋等高脂食物，平日又甚少做運動，身材稍為肥胖，但不屬典型中央肥胖型，因此從來沒預計自己會有心臟病；直至有天上班中突然心口痛，即時入院，接受通波仔後康復出院，但心臟已受到一定的傷害，生活上要作出調節作長遠預防。<\/p>\n

李樹堅建議大家在35歲左右接受體檢，40歲起則年年驗身，及早預防。<\/p>\n

文、圖：許朝茵<\/p>\n

統籌：鄭寶華<\/p>\n

編輯：梁小玲<\/p>\n

https:\/\/health2.mingpao.com\/ftp\/Health2\/20170814\/news\/_14yd101.jpg心臟病發——酷熱下作戶外運動，避免強度太高，否則可能引發心臟病。（Toms93@iStockphoto）（設計圖片，相中模特兒與本文提及疾病無關）;https:\/\/health2.mingpao.com\/ftp\/Health2\/20170814\/news\/_14YD005_.jpg李樹堅（圖：許朝茵）;<\/inline><\/p>\n","protected":false},"author":2,"featured_media":9284,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"rank_math_lock_modified_date":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[3],"tags":[527,229,964,965],"class_list":["post-9192","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-3","tag-527","tag-229","tag-964","tag-965"],"publishpress_future_action":{"enabled":false,"date":"2026-11-16 13:26:44","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts\/9192"}],"collection":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/comments?post=9192"}],"version-history":[{"count":0,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts\/9192\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/media\/9284"}],"wp:attachment":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/media?parent=9192"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/categories?post=9192"},{"taxonomy":"post_tag","embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/tags?post=9192"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}