课件：医学传媒cardiology--英文教学1AS.pptVIP

three to four times higher in regular smokers with a dose-response relationship. For CHD, the benefits of quitting smoking are dramatic: CHD incidence in ex-smokers falls to near nonsmoking levels in 2 years 这张图中，不同的曲线代表了不同水平的收缩压，收缩压越高冠心病危险也大。同一曲线curve代表收缩压相同脉压不同，但可以看到，尽管收缩压不变，脉压pulse pressure增加冠心病的危险也增加，是独立的因素，而收缩压越高脉压带来的影响也越大，这是值得我们重视的。 如果将已知糖尿病和新发现的糖代谢异常患者归入总体患者群中，急诊入院和选择性elective诊疗患者的结果就如这张幻灯片所示。 然而，它们之间的区别不是很大。无论是急诊入院还是择期入院的心血管疾病患者，70％左右合并高血糖。其中30％是已知糖尿病患者，10％－15％是新诊断糖尿病，25％－26％患者糖调节受损impaired glucose tolerance。 冠心病等危症：CHD risk equivalents Abdominal aneurysm；peripheral vascular disease；carotid artery disease；stroke coronary heart disease (CHD), stroke, and peripheral arterial disease (PAD). Renal, retinal artery * BMI body mass index * CCB calcium channel blocker ACEI angiotensin-convertion enzyme inhibitor * 锐缘支 * 左房斜静脉 后左室间支 左室后静脉 * * * * Company Logo Smoking smokers are twice as likely to develop atherosclerosis and coronary artery disease as are non-smokers. 收缩压和脉压对冠心病危险性的联合影响 The Framingham Hear Study；入选者年龄50岁 Stanley S, et al. Circulation 1999;100:354 30 40 50 60 70 80 90 100 110 0.5 1.0 1.5 2.0 2.5 3.0 血压(mm Hg) 冠 心 病 危 险 率 SBP 170 mm Hg (P=.0487) SBP 150 mm Hg (P=.0194) SBP 130 mm Hg (P=.0086) SBP 110 mm Hg (P=.2076) Hypertension-Modifiable risks(3) * Company Logo 急诊入院 择期患者 29% 22% 31% 3% 15% 34% 22% 30% 4% 10% NGT IFG（6.1mmol/L） IGT Known DM New DM The Euro Heart Survey on diabetes and the heart，European Heart Journal (2004) 25, 1880–1890 Diabetes mellitus -Modifiable risks(4) Ⅲ Treatment of AS * Company Logo Ⅲ Treatment of AS education life style change drugs intervention or surgery * Company Logo 3.1 Education make patients know: what is AS, what are risks, what is results of AS, How to control AS, What they can do for themselves * Company Logo 3.2 Life Style Change body weight control: less food, more exercise; more vegetable, less fat 管住嘴，迈开腿 BMI=24 moderately intense physic