课件：感染与心血管疾病.ppt

TABLE I. Infectious Agents Implicated in Atherosclerosis 传染性病原体在动脉粥样硬化中的作用已经被公认为一个多世纪。William Osler是第一个提出急性感染的在动脉粥样硬化的发病机制一个主要人物。在20世纪初,一些先驱科学家利用一些传染性病原体(伤寒沙门氏菌、链球菌等)诱导动脉粥样硬化动物模型。1970年代末,科学家开始研究疱疹病毒、衣原体肺炎的作用,这一努力恰逢新出现的证据表明动脉粥样硬化炎性疾病。许多科学家在传染性病原体这方面进行了研究,但没有人证明这些病原体是导致急性冠脉病变的原因，也没有必然性。衣原体肺炎研究最为广泛,但大型临床试验的结果对这种疾病应用抗生素很大程度上是令人失望的。 The role of infectious agents in atherosclerosis has been recognized for more than a century. William Osler??was one of the first to propose a major role for acute infection in the pathogenesis of atherosclerosis. In the early 20th century, a few pioneer scientists used several infectious agents (Salmonella typhi, streptococci, etc.) to induce atherosclerosis in animal models. By the late 1970s, scientists began to study the role of herpesviruses and?Chlamydia pneumoniae?and, later, ofHelicobacter pylori,?Mycoplasma pneumoniae,?Porphyromonas gingivalis, enterovirus, and a growing list of other agents in atherogenesis (Table I).??This effort coincided with the emergence of new evidence pointing to atherosclerosis as an inflammatory disease.??The role of infection in endothelial injury and vascular wall inflammation came under scrutiny.??Many infectious agents have been investigated in this regard, but none of them has proved to play a causative and specific role.?Chlamydia pneumoniae?has been studied the most extensively, but the results of large clinical trials of antibiotics against this disease have been largely disappointing. * 这张图显示了流感对凝血系统的影响。 Effects of Influenza on the Coagulation System流感可导致促炎因子的数量、凝血因子大大增加,它导致内皮功能障碍,增加血浆粘度、心动过速、内源性儿茶酚胺的释放。临床流感也与心理压力有关,脱水导致低血压,缺血和血浓缩,血氧不足,需求。 Van Lenten和同事已经表明,流感降低高密度脂蛋白保护冠脉血管的作用。 Influenza is associated with a greatly increased number of proinflammatory, prothrombotic cytokines, and it causes endothelial dysfunction, increased plasma viscosity, tachycardia, and release of endogenous catecholamines. Clinical flu is also associated with psychological distress, dehydration leading to hypotension, and h