冠心病动脉粥样硬化发病机制及其防治 PPT课件.ppt

冠心病冠心病--动脉粥样硬化发动脉粥样硬化发病机制及其防治病机制及其防治动脉粥样硬化动脉粥样硬化--冠心病冠心病--脑卒中脑卒中的的发病机制发病机制?脂代谢紊乱学说-----1973~1994HDL-LDL 阴阳平衡失调?内皮功能障碍学说--1993~2005NO-ET凝血-血管舒缩阴阳平衡失调?慢性炎症学说-------1999~2005炎症-抗炎症自主神经阴阳平衡失调ASStroke CHD-ACSHypertentionChronic HFDMSCDRf HT/DM CHD CHF StrokeR-AS all Vaso ACS LVH C-AS 1-凝血-脂质代谢障碍-失衡2-内皮-血管收缩障碍-失衡3-炎症-自主神经障碍-失衡ASASET cell & AS/CHDET cell & AS/CHD动脉粥样硬化脂代谢紊乱学说调脂治疗--脂代谢平衡?History and update: ? LDL-oxLDL-foam cell?Animal Models and questions哈尔滨治疗冠心病医院哪家好:nk/gxb/平滑肌移行泡末细胞形成T细胞激活血小板粘附聚集白细胞粘附侵入从阴阳五行-动态平衡看LDL-HDL的正常紊乱;正常-紊乱, 阴阳五行- 动态平衡LDL-HDL;血管收缩舒展;交感-副交感;促凝与抗凝;?TC/HDL(>5) or LDL/HDL(>) 平衡?HDL< 低?LDL> 高?TG > 高?TC > 高ET cell & AS/CHDET cell & AS/CHD2004-7-31 Xi2004-7-31 Xi’’an an SymposiumSymposiumLIPIDs and AtherosclerosisLipoprotein Classes and Lipoprotein Classes and InflammationInflammationDoi H et al. Circulation 2000;102:670-676; Colome C et al. Atherosclerosis 2000;149:295-302; Cockerill GW et al. Arterioscler Thromb Vasc Biol 1995;15:1987-,,VLDL, and VLDL, and their catabolic their catabolic remnantsremnants> 30 nm> 30 nm2020––22 nm22 nmPotentially proinflammatoryPotentially proinflammatory99––15 nm15 nmPotentially anti- Potentially anti- inflammatoryinflammatoryLDLLDLLDLLDLMiyazaki A et al. Biochim Biophys Acta 1992;1126:73- LumenVessel LumenMonocyteMonocyteModified LDLModified LDLMacrophageMacrophageMCP-1MCP-1AdhesionAdhesionMoleculesMoleculesCytokinesCytokinesHDL Prevent Formation of Foam Cells-HDL Prevent Formation of Foam Cells-11IntimaIntimaHDL Promote Cholesterol EffluxHDL Promote Cholesterol EffluxFoam Foam CellCellLDLLDLLDLLDLMackness MI et al. Biochem J 1993;294:829- LumenVessel LumenMonocyteMonocyteModified LDLModified LDLMacrophageMacrophageMCP-1MCP-1AdhesionAdhesionMoleculesMoleculesCytokinesCytokinesHDL Inhibit the Oxidative Modification of LDL-HDL Inhi