Hypertensionandvascularinjury高血压与血管损伤.pptVIP

Vascular injuries in Hypertension Our approach 高血压时是否存在血管结构与功能异常? 血管结构与功能异常的机制? 降压药物能否改善异常的血管结构? 用于临床的无创性血管功能检测指标有哪些? 怎样寻找血管损伤的生物标志? Part I The change of Vascular structure and function in hypertension The mechanism of abnormal structure The effect of losartan and spironolactone on collagen and elastin of thoracic aorta. The change of Vascular structure and function in hypertension Vascular structure: Mass collagen elastin Vascular function : PWV Stress–strain relationship of the aorta Vascular function in hypertensive rats The mechanism of abnormal structure in vascular wall Angiotensin II Reactive oxygen species (ROS) CTGF Inflammation Ang II-induced ROS formation Effect of ROS on AngII-induced collagen expression Inflammatory mediators mRNA expression confirmed by Real-time PCR Inflammatory mediators protein expression or secretion IL-6 secretion from AF ICAM-1 expression in AF ELISA (n=4) Western blot (n=4) Effect of treatment on vascular structure and function Angiotensin II receptor blockers (ARB) Aldosterone antagonist (spironolactone) Antioxidant (apocynine) PWV PWV Part II Evaluation of vascular injury in the patients with hypertension Is there an earlier marker to predict the hypertension complications ? Non- invasive examination of vascular structure and function 血管结构检查： 动脉内中膜厚度 ( IMT ) ——判断有无斑块 踝臂血压指数 ( ABI ) ——判断有无下肢动脉闭塞 血管功能检查： 动脉脉搏波传导速度（PWV）—— 判断血管僵硬度 中心动脉反射波增强指数（CAI）—— 判断中心动脉僵硬度 中心动脉脉搏压（CPP）—— 判断中心动脉僵硬度 动态动脉硬化指数（AASI）——判断整体动脉硬化情况 大小动脉弹性指数（C1/C2） —— 判断全身大小动脉弹性 血流介导的血管舒张功能（FMD） ——判断内皮功能 高血压组与正常对照组一般资料的比较(± s ) 高血压组与正常对照组血清OPN与hs-CRP浓度的比较(±s ) 血清hs-CRP与OPN的相关性 Ln(hs-CRP)、OPN与多种危险因素的相关性分析 各种相关因素的工作特征(ROC)曲线下面积比较 相关因素的Logistic逐步回归分析 MMP-2、MMP-9、TIMP-1 levels between hypertensives and normotensives MMP-2, MMP-9, TIMP-1, OPN and CRP between CKD groups in hypertensive