(精选)【医学课件大全】Antiathrosclerotic drugs (68p)教学课件.pptVIP

Lou Hai-Yan;Introduction  Atherosclerosis（AS） Ross R: Atherosclerosis is an inflammatory disease;动脉粥样硬化斑块肉眼观察;动脉粥样硬化显微镜观察;主要;危险因素 损伤血管内皮 MC向VEC粘附 MC进入内皮下 MФ  泡沫细胞 脂肪条纹 AS斑块  凡能抑制AS病变发生和发展的 药物都可能是抗AS药;Intima;Intima;Intima;Treatment ; ;1. The composition of blood lipid;我国人群血脂的年龄和性别分布;2. The Composition and Function of Lipoprotein;0.95;;【physiological function of lipoprotein】;LDL;;The aims level of modulating lipids;;【Type of Hyperlipoproteinemia】;　 ; 1. Statins (他汀类） (Inhibitors of HMG-CoA reductase);　;Pharmacological effects ; Mechanism;乙酰CoA;乙酰CoA;;; Pharmacokinetics ;Clinical uses; WOSCOPS (West of Scotland Coronary Prevention Study )： Pravastatin(普伐他汀) 40mg/d,TC↓20%，LDL-C↓26%，TG↓12%，HDL-C↑5%，CHD事件的相对危险性↓31%，心血管病总死亡率↓32%。 4S： Simvastatin(辛伐他汀) 20～40mg/d，TC、LDL-C、TG分别↓25%、35%和10%, HDL-C ↑8%，心血管疾病总死亡的相对危险性↓30%, 冠心病死亡相对危险性↓42%。 ; Adverse reactions; 拜斯亭事件;横纹肌溶解症 Rhabdomyolysis; Drug interaction;;2. Bile acid-binding resins (胆汁酸结合树脂) ;Pharmacological effects:;;Clinical uses IIa and IIb hyperlipoproteinemia High dosage: 20~30g/d ;;; ; Gemfibrazil (吉非贝齐, 诺衡) Fenofibrate (非诺贝特, 力平脂) Benzafibrate (苯扎贝特, 必降脂) ;Pharmacological Actions;Mechanism:; 2.Anticoagulation and Antithrombosis 3. Antiinflammation ; Clinical uses;5. Lp(a)-lowering Drugs Elevation of blood Lp(a) is a independent risk factor，and a risk factor of restenosis after percutaneous transluminal coronary angioplasty Lp(a) can inhibit activation of plasminogen competitively, advance thrombus ; OX-Lp（a）can induce endothelium to express more P-selectin and strength the adhesion of MC ;降Lp(a)的药物 ; Section 2 Antioxidants ;1．OX-LDL促进AS病变发生和发展 ①损???血管内皮, 促MC向内皮粘附和转移。 ②阻止Mф返回血流。 ③ Mф大量摄取OX-LDL→泡沫细胞。 ④促EC释放PDGF。 ⑤促