If these abnormalities are found, health management should keep up quickly
The physical examination is done every year, what is the key to check?
Elevated blood pressure, high uric acid, abnormal tumor markers... What should be the focus of attention in the physical examination report?
Which indicators of abnormality may be a signal of a specific disease?
How should health management be carried out after physical examination?
Experts provide detailed answers to these questions.
40 years old is an important cut-off point for physical examination
"Different from clinical diagnostic physical examinations for a certain disease, the subjects of healthy physical examinations are mainly healthy people and sub-healthy people." Xu Aimin, deputy director of the Physical Examination Center of Beijing Chaoyang Hospital, introduced that since there are no chief complaints of diseases, health physical examinations focus on Two aspects: tumor risk factors and chronic disease risk.
Experts remind that the age of 40 is an important cut-off point for health checkups.
The physical examination for people under the age of 40 is mainly to screen potential risk factors for chronic diseases, such as blood pressure, blood lipids, blood sugar, uric acid and other indicators.
People over the age of 40 need to pay more attention to tumor screening in addition to screening for chronic diseases.
"We should combine family medical history, personal work and living habits, and at the same time combine the high risks of routine physical examination screening, and choose a more targeted tumor screening plan according to our own conditions." Xu Aimin said. For high-risk groups of tumors, annual blood tumor marker examinations, low-dose chest CT, breast, thyroid, and abdominal ultrasonography, etc., and gastrointestinal endoscopy when necessary.
Xu Aimin introduced that for common cancers, there are the following screening recommendations——
lung cancer screening
High-risk groups: over 40 years old; long-term active or passive smoking; history of occupational exposure (asbestos, beryllium, radon, arsenic, uranium, etc.); history of malignant tumors (lymphoma, head and neck cancer, or smoking-related cancer ); a history of chronic obstructive pulmonary disease or diffuse pulmonary fibrosis; a family history of lung cancer in a first-degree relative.
Screening method: low-dose spiral CT of the chest once a year. If pulmonary nodules are found, follow the doctor's advice or go to a specialist for further examination and monitoring.
Stomach Cancer Screening
High-risk groups: over 45 years old; long-term living in areas with a high incidence of gastric cancer; Helicobacter pylori infection; previous history of gastric diseases; clear family history of gastric cancer or esophageal cancer.
Screening method: If you have abdominal pain, bloating, acid reflux, heartburn and other symptoms of upper abdominal discomfort, and chronic gastritis, you should do regular gastroscopy according to the doctor's advice.
liver cancer screening
High-risk groups: 40-69 years old; people with hepatitis B, hepatitis C, or carriers of hepatitis B, hepatitis C virus; liver cirrhosis; alcoholic liver disease or other liver diseases; family history of liver cancer.
Screening method: Abdominal ultrasonography every six months; high-risk groups receive a serum alpha-fetoprotein test every six months. It is recommended to do hepatitis B virus surface antigen and hepatitis C antibody tests at the same time. If abnormalities are found, further enhanced CT examinations should be performed.
breast cancer screening
High-risk groups: patients with breast ductal or lobular dysplasia or lobular carcinoma in situ; patients who have received chest radiotherapy before the age of 30; family history of breast cancer but do not meet the criteria for suspected patients with hereditary breast and ovarian cancer syndrome women.
Screening method: It is recommended to carry out breast cancer screening at the age of 40 or earlier; breast ultrasound examination every 6-12 months, high-risk groups can do mammography examination according to their own conditions.
cervical cancer screening
High-risk groups: women who are married or have had sex for 3 years; women who have HPV infection, immunocompromised, intrauterine exposure to diethylstilbestrol, and women with a history of cervical lesions.
Screening methods: cervical cytology and human papillomavirus (HPV) detection can be used.
People who have been vaccinated against HPV should also be screened regularly.
"In addition, tumor markers can be used as an auxiliary diagnostic method for tumors, but the detection of elevated tumor markers alone cannot be used as a basis for tumor diagnosis." Xu Aimin introduced that some benign diseases can lead to elevated tumor markers, while Even if you have already suffered from cancer, such as lung cancer, gastric cancer, intestinal cancer, etc., the tumor markers will not always increase.
Generally speaking, when the physical examination finds that tumor markers are abnormally elevated, the doctor will generally recommend another review.
If the index is only slightly increased, and the changes in multiple inspections are not large, and there are no symptoms, there is no need to worry.
If the reexamination results are still abnormally high, it is necessary to find the corresponding specialist doctor for analysis and further examination as soon as possible.
Metabolic syndrome is ultimately a lifestyle disease
With changes in lifestyle, overweight/obesity, hyperlipidemia, and hypertension have become common abnormalities found in physical examinations.
Xu Aimin introduced that these abnormalities do not exist in isolation, but are closely related. "They can be collectively referred to as metabolic syndrome, which is a group of complex metabolic disorders."
How to tell if you have metabolic syndrome?
Xu Aimin introduced that the following 5 diagnostic criteria can be diagnosed as metabolic syndrome if any 3 or more of the following 5 diagnostic criteria are met after diagnosis and treatment by a doctor.
Abdominal obesity (i.e. central obesity): waist circumference ≥ 90 cm for men, waist circumference ≥ 85 cm for women;
High blood sugar: fasting blood sugar ≥ 6.1 mmol/L and (or) 2-hour postprandial blood sugar ≥ 7.8 mmol/L, or diabetic patients who have started treatment;
High blood pressure: blood pressure ≥ 140/90 mm Hg, or patients who have been diagnosed with hypertension;
Fasting triglycerides ≥ 1.7 mmol/L;
Fasting high-density lipoprotein cholesterol <1.04 mmol/L (female), 0.9 mmol/L (male).
According to experts, body mass index is an internationally accepted method for judging weight, and its calculation formula is BMI=weight (Kg)/height square (㎡).
For adults aged 18 and over, when the BMI is lower than 18.5, it is underweight; if 18.5 ≤ BMI < 24, it is normal; if 24 ≤ BMI < 28, it is overweight; if BMI ≥ 28, it is obese.
It should be noted that even if the body mass index is normal, people with excessive waist fat accumulation, as long as the waist circumference of men is ≥ 90 cm and the waist circumference of women is ≥ 85 cm, they are also obese.
"To maintain a healthy weight, you must follow the principle of 'keep your mouth shut and open your legs', and insist on combining diet control with increasing exercise." Xu Aimin emphasized that you can seek help from a nutritionist or doctor, and don't blindly take weight-loss drugs.
"If the blood pressure is found to be high by accident during physical examination or seeing a doctor, it is necessary to strengthen monitoring and take more measurements at different time periods. If the blood pressure is still abnormally high, it is necessary to go to the hospital in time." Xu Aimin introduced, before using In the case of antihypertensive drugs, if the blood pressure in the office is measured ≥140/90 mmHg three times on different days, it can be diagnosed as hypertension.
The intake of sodium salt is positively correlated with the increase of blood pressure. Therefore, hypertensive patients should pay special attention to controlling the daily salt intake. It is recommended that the daily salt intake of adults should not exceed 5 grams.
High blood lipids mainly depends on four indicators, namely total cholesterol, low-density lipoprotein cholesterol (commonly known as "bad cholesterol"), high-density lipoprotein cholesterol (commonly known as "good cholesterol") and triglycerides.
According to experts, people with high blood lipids must limit the intake of cholesterol, eat less fatty meat, egg yolk, fish roe, animal offal, etc., and limit the intake of foods containing trans fatty acids, such as biscuits, pastries, potato chips, Bread, potato chips, etc.
"In the final analysis, metabolic syndrome is a disease caused by an unhealthy lifestyle." Xu Aimin emphasized that only by developing a healthy lifestyle with a reasonable diet, moderate exercise, smoking cessation, alcohol restriction, and psychological balance can we truly stay away from metabolic syndrome.
Health management pays attention to the unity of "knowledge, faith and action"
"In the past, everyone only paid attention to health checkups, and did not realize that health management should be carried out in a timely manner after the checkup." Xu Aimin said that health checkups are to discover risk factors for health and carry out early intervention. "Physical checkups are just the beginning. Our purpose is to improve health. Timely health management is the concrete embodiment of implementing the requirements of the Healthy China Action to move forward and put prevention first."
"Health management should follow the principles of 'knowledge, faith, and action'." Xu Aimin said, let people obtain correct health care knowledge and information, establish positive and correct beliefs and attitudes, and then change the basis of health-related behaviors and mobilize people's motivation. Subjective initiative, to take the initiative to change bad living habits.
Take high blood uric acid as an example, men and postmenopausal women have blood uric acid > 420 micromol/L, and premenopausal women have blood uric acid > 357 micromol/L, which is called hyperuricemia.
Elevated blood uric acid is the material basis for gout, and only when it develops into inflammatory arthritis or tophi can it be called gout.
Clinically, when the blood uric acid level is higher than 480 micromol/L, whether you have gout or not, you should actively reduce uric acid.
Experts pointed out that for people with high uric acid, it is very important to control the intake of food purines.
Common foods with high purine content include animal offal, seafood, beer, and thick gravy soup.
At the same time, drink plenty of water, ensuring more than 2000 ml of drinking water per day, which can promote the excretion of uric acid from the urine and reduce the formation of stones. It is the most important, simple, economical and effective way to treat hyperuricemia.
In addition, it is necessary to strengthen exercise. It is recommended to choose the aerobic exercise that your body can tolerate. Generally, it should be 3-5 times a week, and each time should be 30 minutes.
Regarding the fatty liver issue that the public is concerned about, according to experts, simple fatty liver itself is not a serious disease, but if left alone, it is likely to continue to evolve and develop: simple fatty liver → steatohepatitis → liver fibrosis → liver cirrhosis → liver cancer .
"If detected early and treated actively, simple fatty liver can be completely recovered, and most fatty liver can also return to normal." Xu Aimin introduced that if left unattended, some fatty liver patients will develop into fatty liver fibrosis and liver cirrhosis , Some elderly patients will also develop hepatocellular carcinoma, causing serious consequences.
"Many patients ask if there is any specific drug for fatty liver. In fact, weight loss is the best specific drug for fatty liver." Xu Aimin said that simple fatty liver does not need medication, relying on self-effort, from controlling diet, persisting Exercise and a regular schedule are ideal for weight loss.
What needs to be reminded is that the weight loss should not be too fast, and it is best to control it within 0.5-1 kg a week. If the body fat is decomposed too much in a short time, exceeding the metabolic capacity of the liver, the fatty liver will aggravate instead.
Wang Meihua