老年冠心病治疗策略的演变医学课件.pptVIP

老年冠心病治疗策略的演变The Strategic Changes of ElderlyCoronary Heart Disease Treatment;老年冠心病临床特点Clinical Features of Elderly CHD;冠心病治疗观念的改变Novel Changes in Concept of Elderly CHDTreatment;Luminal Stenosis 管腔狭窄;Degree of Coronary Stenosis 冠脉狭窄程度 ;急性心梗前的冠脉狭窄程度Coronary Artery Stenosis pre-AMI;降脂疗法降低心脏事件但并不改变管腔狭窄Lipid-lowering Therapies Decrease Cardiac Events but Not Stenosis;Coronary Artery Stenosis And Cardiac Events冠脉狭窄与心脏事件;Concept of Vulnerable Plaque易损斑块概念的提出;;多方位策略演变 Many sided strategic changes;CHD develops in 20~30 years 冠心病慢性病程 Plaque rupture occurs in 2~3 hrs 斑块破裂快过程;冠脉介入治疗的短处Limitations of PCI;COURAGE临床试验 ;;两组主要终点比较The comparison of endpoints with two groups;随访心绞痛缓解率Freedom from Angina During Long-Term Follow-up;震撼全球心血管病学界Grobal impact on cardiological field;两组总生存率Overall Survival;稳定易损斑块的重要作用Stabilization of Vulnerable Plaques; Lipid Deposit 脂质沉积 ;逾百年之脂质沉积学说Lipid Deposition Theory;Inflammatory theory of AS was first presented by Virchow in 1856. 炎症理论的提出 “Endarteritis deformans” or atheroma - a product of an inflammatory process within the intima with the fibrous thickening evolved as a consequence of a reactive fibrosis induced by proliferating connective tissue cells within the intima. The theory did not raise great attention at that time. 当年未获关注;In recent years, AS was shown to have the basic manifestation of inflammation 炎症反应的基本表现 Degeneration Exudation Proliferation The cell-cell interaction is similar to other chronic inflammation diseases such as rheumatoid arthritis, chronic pancreatitis and hepatic cirrhosis. AS was no longer regarded as a simple disease of lipid deposition in the vessel wall, but also an advanced inflammatory reaction. In AS plaque of human, there was also evidence of several pathogens 病原 Chlamydia pneumoniae Cytomegalovirus Herpes virus Helicobacter pylori;动脉粥样硬化炎症学说Inflammation Theory;动脉粥样硬化的新概念The New Concept of AS;Inflammatory BiomarkersAS炎症生物学标志物Inflammatory Biomarkers;AS炎症生物学标