病理学_心PPT课件.ppt

There is marked left ventricular hypertrophy, with asymmetric bulging of a very large interventricular septum into the left ventricular chamber. This is hypertrophic cardiomyopathy. * 限制性心肌病Restrictive cardiomyopathy progressive fibrosis of the endocardium and subendocardial myocadium * This section of myocardium demonstrates amorphous deposits of pale pink material between myocardial fibers. This is characteristic for amyloid. Amyloidosis is a cause for infiltrative or restrictive cardiomyopathy. It is a nightmare for anesthesiologists when intractable arrhythmias occur during surgery on such patients. * 3. 心肌纤维化Myocardial fibrosis 4. 冠状动脉性猝死sudden coronary death * 高血压病Hypertension 诊断标准Diagnostic criteria sustained diastolic pressure above 90 mmHg and/or sustained systolic pressure above 140mmHg * 分类Classification Primary(essential) hypertension Secondary(symptomatic) Benign (chronic) hypertension Malignant(accelerated) * 病变Morphology (1) 良性高血压Benign hypertension 机能紊乱期Stage of dysfunction 动脉病变期Stage of artery lesion 基本病变the basic lesion 细动脉硬化 arteriolosclerosis 内脏病变期Stage of organ dysfunction * 高血压心脏病 Hypertensive heart disease 病变 向心性肥大Concentric hypertrophy 离心性肥大 Ecentric hypertrophy 临床病理联系 * * * 左心室向心性肥大 * * 左心室失代偿性扩张 * * 细动脉性肾硬化Arteriolar nephrosclerosis (primary granulo-contracted kidney) 镜下Microscopic change 肾血管,肾小球,肾小管,肾间质 大体Gross alteration 颗粒性固缩肾 * 高血压固缩肾 * * * * * * * * * 高血压脑Hypertensive brain hypertensive encephalopathy Hemorrhage of brain Softening of brain 视网膜病变Lesions of retina * 侧 脑 室 出 血 * 呈银丝状眼底细动脉 * (2) 恶性高血压Malignant hypertension 基本病变Basic lesion: 坏死性细动脉炎necrotic arteriolitis 增生性小动脉硬化proliferating arteriosclerosis 主要受损器官The major injured organs: kidney and brain * 病因和发病学Etiology and pathogenesis 病因Causes Genetic factors Environmental factors Dietary factors: Na+, K+,Ca2+ Social factors psychological str