英心血管病.ppt

Diseases of the Cardiovascular System The cardiovascular system  Atherosclerosis 动脉粥样硬化 Hypertension 高血压 Rheumatism 风湿病 Section 1 Arteriosclerosis（动脉硬化） Arteriosclerosis encompasses any condition of arterial vessels that result in a thickening or hardening of the walls. It generally includes three conditions: 1. Arteriolosclerosis（细动脉硬化） 2. Monckeberg’s sclerosis/ Medial calcification 3. Athrosclerosis （动脉粥样硬化） What is Atherosclerosis (AS)? Definition: Atherosclerosis（动脉粥样硬化）is a degenerative（退变性的）disease of large and medium-sized arteries, characterized by intimal lipid deposition and fibrosis. Etiology and pathogenesis（病因学与发病机制） Etiology （病因学）  Causes: not clear. Predisposing factors（潜在因素）: 1.hyperlipidemia: cholesterol and triglyeride（胆固醇与甘油三脂） 2.Hypertension（高血压） 3.smoking 4.Diabetes（糖尿病） 5.genetic factor 6.other Pathogenesis Lipid theory of atherogenesis: Elevation of the blood levels of cholesterol and triglyeride（ TG） → insuccation（浸润） of these substances into the arterial intima（内膜）→ accumulate→ atherosclerotic lesion（病变）. Types of atherosclerotic lesions 1.Fatty streak （脂纹） Location: include the abdominal aorta（腹主动脉） and large arteries of the lower limb, the coronary arteries, and the circle of willis. Grossly: pale yellow lines running parallel to one another downward for several centimeters. Each streak is only 1 to 2 mm wide. LM: The lipid is found (1) in endothelial cells（内皮细胞） overlying（覆盖 ）the streaks, (2) within foam-cells (泡沫细胞) The foam- cells arise from ①lipid-containing smooth muscle cells ② macrophages（巨噬细胞） ???????? ????? 2. fibrous plaque（纤维斑块） (1) The fatty material accumulates to form a fatty pool at the heart of the developing plaque. (2) Overgrowth of fibrous tissue around the fatty pool → fibrous plaque. Grossly: pale yellow→ pale, slightly elevated plaque LM: fi