济宁医学院病理学课件心血管系统疾病.pptVIP

急性感染性心内膜炎常为脓毒血症或败血症急性心内膜炎急性心内膜炎急性心内膜炎急性心内膜炎Acutebacterialendocarditis(ABE)Acutebacterialendocarditis(ABE)亚急性感染性心内膜炎

Bacteremia刷牙拔牙导管Getcatheterized直肠镜或膀胱镜ProctoscopedorcystoscopedColoncancer静脉注射无菌操作不严Preexistingcardiacabnormalities心瓣膜异常Prostheticheartvalves人造瓣膜Intravenousdrugabuse静脉注射毒品易感因素:CalcificaorticstenosisRheumaticCongenital“Hyaline”=benign.“HYPERPLASTIC”=MALIGNANTHTN.SYS2001)ONIONSKIN2)“FIBRINOID”NECR.Section4风湿病Rheumatism全身、自体免疫病GroupAbeta-hemolyticstreptococcalthroatinfection（5-15yokids）Mproteinand…1-3％patients炎症累及器官风湿性心脏病风湿性关节炎皮肤风湿性动脉炎风湿性脑病subcutaneousnodule风湿病的基本病理变化变质渗出期增生期或肉芽肿期：阿少夫小体瘢痕期急性风湿性心脏炎慢性风湿性心瓣膜病风湿性心脏病急性风湿性心脏炎心外膜炎－纤维素性炎心肌炎－阿少夫小体心内膜炎－疣状赘生物Rheumaticpericarditis风湿小体AschoffnodulesAnitschkowcellsintheAschoffsnoduleAnitschkowcellsintheAschoffsnoduleAnitschkowcells风湿性心内膜炎慢性风湿性心瓣膜病瓣膜变形二尖瓣二尖瓣+主动脉瓣膜狭窄stenosis瓣膜关闭不全regurgitation继发感染性心内膜炎95%25%fishmouthshapeSection5感染性心内膜炎InfectiveEndocarditis含病原体的赘生物二尖瓣和主动脉瓣、右心的瓣膜（吸毒）赘生物形状与病原体，治疗有关急性——亚急性Morphology病理：Section3高血压病Hypertension舒张压持续高于90mmHg或收缩压持续高于140mmHg缺血性心脏病IHD心衰Heartfailure主动脉夹层Aorticdissection中风Stroke肾衰Renalfailure25％Hypertensionisoneofthemostimportantriskfactorsforcardiovascularandrenaldiseases.Currently,approximately73millionadultsintheUnitedStatesandapproximately1billionadultsworldwidehavehypertension,andtheprevalenceisincreasing.(Heartdiseasestrokestatistics:2008updateat-a-glance.Dallas:AmericanHeartAssociation,2008.(AccessedNovember13,2008)Studiescomparingtheeffectsofantihypertensivemedicationswiththoseofplacebohaveshownconsistentlythatloweringbloodpressureisassociatedwithmajorreductionsintheincidenceofcoronaryevents,strokes,andcongestiveheartfailure.Thesebenefitshavebeenobserved