19.病理解剖学课件cardiovascular diseases-相磊.pptx

Diseases of The Cardiovascular System;;Cardiovascular System The blood vessels The heart;large：;;medium-sized artery Low power： 1.Tunica intima 2.Tunica media 3.Tunica adventitia;Major Disorders of CVS;Atherosclerosis;Arteriosclerosis;Definition: Atherosclerosis is a disease which affects large and medium-size arteries, characterized by intimal fatty deposits followed by proliferation of smooth muscle cells and connective tissue, ultimately with arteriosclerosis. A systemic disease relating to the metabolism of lipid. Morbidity:;Atherosclerosis-risk factors;Hyperlipidemia (one of the most important risk factors) Hypercholesterolemia-more responsible than hypertriglyceridemia for atherosclerosis. High LDL, VLDL, TG and apoB cause higher risk; HDL/HDL-C and apoA-Ⅰ acts in reverse, helps prevent atherosclerosis LpA Experimental diets in animals Plaques are mostly cholesterol ;Hypertension Smoking: independent risk factor for IHD Diabetes and hyperinsulinemia Genetic Age and sex Physical and stressful life type Homocysteine Intake of alcohol C-reaction protein Infection;Atherosclerosis-pathogenesis;Chronic endothelial injury Deposition of LDL into vessel wall Modification of lipoprotein by oxidatin Adhesion of blood monocyte to the EC Adhesion of platelet Activated platelet , macrophage release factors Proliferation of SMC in the intima and accumulation of extracellular matrix(collagen) Enhanced accumulation of lipid intracellularly and extracellularly ;Central to this thesis are the following events;the role of lipid: directly impair EC function through increased production of oxygen free radical increase endothelial permeability LDL yield oxidized by macrophages or EC (ox-LDL) ;ox-LDL induce EC dysfunction → increase expression of adhesion molecule →reinforce adhesion between EC and monocyte increase monocyte accumulation (chemotaxis) in lesion ingested by macrophages, thus forming foam cells stimulate release of GFs and cytokines cytotox