内科学 循环系统总论-葛均波.ppt

名人的意外事件 2005年７月２日晚，成功扮演“毛泽东”的特型演员古月在广东省三水区因突发大面积心肌梗死，抢救无效去世，享年66岁。 2005年8月17 日晚，著名表演艺术家高秀敏在长春的家中因心脏病突发辞世，享年46岁。 名人的意外事件 心脏的工作 各部，同时从肺部吸取新鲜血液，以便供左心室下一次收缩使用；右心室吸进从静脉来的、带有大量废物和二氧化碳的血液，这种不新鲜的血通过右心房运送到肺部，在肺部吸收氧气排出二氧化碳后，又变为鲜血流入左心房。 心脏疾病 Determinants of Normal Circulation Preload Afterload Contraction Heart rate Chamber stiffness Oxygen consumption Coronary blood supply Clinical History Chest pain Syncope Fatigue Dyspnea Palpitation Fever Cyanosis Edema Dizziness ...... Surface ECG Major Causes of Death: China MUCA Study1991-1995 surveillance data in 1.5 million population,using MONICA procedure ICD Therapy ICD-Secondary prevention: Meta-Analysis (AVID,CIDS,CASH) Number at risk ICD: 934 715 467 273 159 104 934 715 467 273 159 104 Amio: 932 664 427 248 128 82 932 664 427 248 128 82 Years Years Amio ICD Amio ICD 50 40 30 20 10 0 50 40 30 20 10 0 0 1 2 3 4 5 0 1 2 3 4 5 Connolly SJ. Eur Heart J 2000;21:2071 Death Rhythmogenic death Progress and Perspectives Angiogenesis Implantation of self (autologous) bone marrow stem cells is a relatively simple method for angiogenesis without causing toxicity or immunological rejection Isner JM, et al. J Clin Invest 1999;103:1231-6 Progress and Perspectives Bone Marrow Cells Regenerate Infarcted Myocardium Orlic et al. Nature 2001; 410:701 ? Lin- c-kitPOS BMC from transgenic mice injected in the peri-infarcted left ventricle of female mice after coronary ligation ? Newly formed myocardium occupied 68% of the infarcted portion of the ventricle 9 days after transplanting the bone marrow cells. Developing tissue comprised proliferating myocytes and vascular structures A. Bone marrow cells and myocardial regeneration B. Myocardial repair and connexin Progress and Perspectiv