[临床医学]AS翻译版.pptx

动脉粥样硬化-复杂的系统性疾病目录?什么是动脉粥样硬化?内皮细胞损伤在动脉粥样硬化过程的作用?调脂治疗在动脉粥样硬化屮的作用Agenda? What is atherosclerosis?? What is the role of endothelial dysfunction in the atherosclerotic process?, What is the effect of lipid therapy on atherosclerosis?动脉粥样硬化是一种伴有以LDL-C为主脂质核心的 漫长的炎性疾病Libby P. J Intern Med. 2000;247:349-358.动脉粥样硬化开始于青年时代动脉超生结果(％) s 一 so』Qoso」a>ln<aoua)<5>a)」d25-35 Donor Age (yr)Nissen S. Am J Cardiol. 2001:87(suppl):15A?20A.动脉粥样硬化在起初的很难被检测出来即便存在较大脂 质核心——血管 内腔大小也不会 没有明显官腔大小没 冇明显改变由丁?脂质核心的出 现血管壁结构改变Strong JP, et al. JAMA. 1999;281:727-735. Glagov S, et al. N Engl J Med.1987;316:1371 -1375.危险因素可进一步使动脉粥样硬化恶化，增加CHD 的风险Framingham Interaction of Risk FactorsKannel WB. Importance of hypertension as a major risk factor in cardiovascular disease. In: Genest J, Koiw E.Kuchel O, Boucher R, Nowaczynski W, Rojo-Ortega JM eds. Hypertension: Physiopathology and Treatment. New York, NY: McGraw-Hill Book Co;1977:888-910.鬲血脂导致动脉粥样硬化瓣块的形成IIIHeart Disease: A Textbook of Cardiovascular Disease. 6th ed. Philadelphia, Pa: W.B.Saunders Co; 2001:995-1009. Miller M. Clin Cardiol. 1999;22(suppl 11):11-1-11-6.我们如何阻断这种趋势MO 一一 VIL 一 ZIDeposition and oxidation of LDLInfiltration of monocytes/Fatty streak formationMigration of smooth muscle cells (SMQ/Development of fibrous cap一 SS 抒一 Don一Formation of atheromaStable plaque?Increased growth ? StenosisLibby P. J Intern Med. 2000;247:349-358.Unstable plaque?Plaque rupture?Thrombus/MI一寫 o。稳定斑块的增长会引起血管的闭塞III稳定的斑块Fibrous cap—3LumenT lymphocyteMacrophage foam cell (tissue factor*) g<Acttvate(lw intimal SMC (HLA-DIT)Normal medial SMCLibby P. Lancet. 1996;348:S4-S7.动脉硬化组织切片This high magnification of the atheroma shows numerous foam cells and an occasional cholesterol cleft.不稳定斑块的特征?Libby P. Circulation. 1995;91:2844-2850.斑块的破裂会导致严重的疾病：Ml, UnstableAngina, Stroke, and Peripheral IschemiaStrokeUNSTABLE PLAQUEUnstable anginaMyocardial infarctionMedia-I lymphocytefactor)f - -Activated" Intimal SMC (HLA-DR3 方-NohmI mediolSMCPeripheral ischemiaGlagov S, et al. N Engl J Med