内皮功能和心血管危险因素薛增明ppt课件.ppt

内皮功能和心血管危险因素;David Gutterman, 博士;goals;研究动脉舒张的器官浴漕技术;- 切应力 - 乙酰胆碱 - 缓激肽;;Is NO important?;一氧化氮的生理特点;内皮释放的一氧化氮能保持血管完整性，预防动脉粥样硬化的进展;评价人类内皮功能的方法;;;肱动脉血流介导的血管舒张的特点;Testing NO (2);Impaired no dilation;;Testing NO (2);- from Drexler and Zeiher, Circulation, 1991 ;Testing NO (2);高胆固醇血症患者动脉粥样硬化的逆转;Testing NO (2);Impaired no dilation;Patti et al. Circ. 2005;Impaired no dilation;Impaired no dilation;Testing NO (2);小结;x;叶酸和内皮功能 - 对治疗的交互作用;Novel treatments;blank;summary;blank;blank;抗氧化剂和动脉粥样硬化;抗氧化剂和动脉粥样硬化;;硝酸酯类药物和动脉粥样硬化;目标：减少冠心病和中风所致的死亡率 ??????? 减少冠心病死亡率23.1% ??????? 减少中风死亡率19.1% 目标：减少吸烟，高胆固醇和身体不活动25% ??????? 高胆固醇高胆固醇20.0% ????????减少吸烟12.9% ????????未从事中重度体力活动人群减少2.5% 目标：减少未能控制高血压25% ???????? 减少未能控制高血压8.5% 目标：消除肥胖和糖尿病（增长率0%） ???????? 肥胖增长率1.39% ????????糖尿病增长率0 .28%;肝细胞与内皮功能;TREND quinapril; ;- Traub et al. ATVB 1998;;Brach analyzer;Katz, Circulation 2005;Takase et al. Circ. J. 2006;Patti et al. Circ. 2005;Karatzis et al. AJC 2006;血流诱导的血管舒张 (冠心病 vs. 无冠心病);改善内膜中层厚度的治疗;cGMP;EDHF pathway;叶酸治疗内皮功能不全的效果;一氧化氮合酶亚型;叶酸改善内皮功能的潜在机制;高胆固醇模型:一氧化氮缺失加速动脉粥样硬化;内皮功能不全的机制…;Prog and endo fctn;Prog and endo fctn;Prog and endo fctn;预后：血流介导的血管舒张对内膜中层厚度;Endothelial Function and Cardiovascular Risk;David Gutterman, MD;goals;Organ bath techniques for study of arterial relaxation ;- Shear Stress - Acetylcholine - Bradykinin;;Is NO important?;Physiological Properties of NO;Nitric oxide released from the endothelium maintains vascular integrity and prevents the development of atherosclerosis;Methods of endo human;Susan pitt;Brach analyzer;Charac FMD;Testing NO (2);Risk vs endo fctn;;Testing NO (2);- from Drexler and Zeiher, Circulation, 1991 ;Testing NO (2);Cooke morphol.;Testing NO (2);Impaired no dilation;Patti et al. Circ. 2005;Prog and endo fctn;Impaired no dilation;Testing NO (2);Methods of endo human;x;Folate endo rabelink;Novel treatments;blank;summary;blank;blank;Antiox athero prim;Antiox athero secon;;Nitrates and Atherosclerosis;Goal: Reduce death