19冠心病课程摘要.ppt

* Atherosclerosis is a complex disease. Atherosclerotic plaques can be subdivided in accordance with their age and state of development. It is the newly formed lesions with a large lipid core, thin capped, which are fragile and therefore likely to rupture and lead to an acute ischemic event. * Slide 3 Atherothrombosis: a Generalized and Progressive Process Atherothrombosis is the common underlying disease process for MI, ischemia and vascular death. ACS are classic examples of atherothrombosis (plaque rupture and thrombus formation). ACS (in common with ischemic stroke and critical leg ischemia) are typically caused by rupture or erosion of an atherosclerotic plaque followed by formation of a platelet-rich thrombus. Atherosclerosis is an ongoing process affecting mainly large and medium-sized arteries, which can begin in childhood and progress throughout a person’s lifetime. Stable atherosclerotic plaques may encroach on the lumen of the artery and cause chronic ischemia, resulting in (stable) angina pectoris or intermittent claudication, depending on the vascular bed affected. Unstable atherosclerotic plaques may rupture, leading to the formation of a platelet-rich thrombus that partially or completely occludes the artery and causes acute ischemic symptoms. 冠状动脉粥样硬化性心脏病（Coronary Atherosclerotic Heart Disease, CHD） 循环系统疾病 动脉粥样硬化，是动脉硬化的一种。 特点：动脉管壁增厚变硬，失去弹性和管腔缩小。 受累动脉的内膜有脂质的沉着，复合糖类的积聚，出血血栓形成，纤维组织增生和钙质沉着，并有动脉中层逐渐退变和钙化。 动脉粥样硬化（atherosclerosis，AS) AS累及大型及中型的肌弹力型动脉，以主动脉、冠状动脉及脑动脉为多见，常导致管腔闭塞或管壁破裂出血等严重后果。 动脉粥样硬化（atherosclerosis，AS) 病因 AS病因尚未完全确定，本病是多因素共同作用，遗传为基础，于不同环节所致，这些因素称为心血管危险因素或易患因素。 动脉粥样硬化（atherosclerosis，AS) 病 因 主要危险因素（risk factor）：  年龄 40岁以上 性别 男性多见 吸烟 高血脂 高TC、TG、LDL-C 高血压 代谢综合征 糖尿病和糖耐量异常 (肥胖) 动脉粥样硬化（atherosclerosis，AS) 病 因 次要危险因素 肥胖、活动少、高热量和高脂饮食、CHD家族史、性格急躁；同型半胱胺酸?、胰岛素抵抗、纤维蛋白原?、病毒和衣原体感染 动脉粥样硬化（atherosclerosis，AS) 动脉粥样硬化（atherosclerosis，AS)