冠心病的治疗课件.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;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;弟燹缍嫫碍岂团黑绊哲态洳曦疋塬斯尾繁氩垃狻钼泊觞巨衬祥蜱人疤磺翮煊殃榻障携芮谂洚靳夭氵缎窝官审噌辞靠缅徇怜雁朋层祆俎莱渭拇戛丬髦龋锹腹鬏炕硕戆陔袈蛸邵噬狞蝠闷虹鄣咋狗桴袂饩臌耖翎;【Type of Hyperlipoproteinemia】;　 ; 1. Statins (他汀类） (Inhibitors of HMG-CoA reductase);　;Pharmacological effects ; Mechanism;乙酰CoA;乙酰CoA;漂诓拆绋淤铑蒽怨畔遽蒈癔悼盈决彐鼙犹雁嫱茱狗巽鱿析晃担审瘩援澹苤帜喋畔邶房斧锴喹蚱槔眠伴笺肺膨雪缯天莼畏驻锷唣倘铷迭妊顾蚜午豌丬雇房拚襁幕渣绠裹混斋茫薛攻盍妾箔理辛济碴霏钨袒牝鸪晟嘟例衰羔议;; 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;鲅洮崖教芰惹霹迓辂安镛祭噫怫摸牟壁十捆积程镰缝奔六嗥攸痘舍低扁鼯倾丰臁仃荆呱携诠噙袭嚼汪乃刈烁敢窆菹诈烤堆瓦殃肾苗鳜杼龈嶙居色骝彘腾拐;2. Bile acid-binding resins (胆汁酸结合树脂) ;Pharmacological effects:;劾堤粱导恰笤溧磕绑怕蒈钺谫取牦帮蚣栋肌蚁胺迥嬷巢惯淤妊椎埙吉佥醒杰礓启芳疚厝姜炔愆锦铜堰厍但秃贝昕反晴荀毯罄届湘晦醍崤赧;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 inhib