病理学动脉粥样硬化高血压课件.pptVIP

心血管系统疾病动 脉 粥 样 硬 化（Atherosclerosis, AS）;Case Report;尸检(autopsy) 左冠状A前降支动脉粥样硬化,血栓形成，管腔闭塞。前壁心肌梗死 Coronary atherosclerosis with thrombosis and infarction;Coronary atherosclerosis with thrombosis and infarction;血脂过多沉积于动脉内膜并形成坏死粥糜样物质的动脉硬化性疾病 血脂异常及血管壁成分改变有关的动脉性疾病;How to understand atherosclerosis?;Definition: 动脉硬化 (Arteriosclerosis) (Hardening of Arteries) ●动脉粥样硬化(Atherosclerosis ) 大、中 A, 粥样硬化斑块 ●动脉中膜钙化(Medial Calcification Sclerosis) 颞A、四肢A,临床意义不大 ●细动脉硬化(Arteriolosclerosis) Hyaline degeneration 高血压病 ; (1)脂斑脂纹（fatty spot streak) 黄色斑点或条纹;fatty patch;fatty spot plaque; Basic pathology: atherosclerosis;fibrous plaque; (3)粥样斑块 (atheromatous plaque) “粥瘤”（atheroma） ●斑块内坏死黄色粥糜 样物质 ; Basic pathology: atherosclerosis; Basic pathology: atherosclerosis; Basic pathology: atherosclerosis; Basic pathology: atherosclerosis; 表层— 纤维帽,大量胶原玻变,基质,SMC 深部— 大量无定形坏死物,胆固醇结晶,钙化 底周— 肉芽组织，少许FC、淋巴C 中膜— SMC萎缩变薄,弹力纤维破坏 ;复合病变(Complicated lesion) ①斑块内出血 ②斑块破溃 ③血栓形成；④钙化；⑤动脉瘤形成;动脉粥样硬化—出血(Hemorrhage);动脉粥样硬化—溃疡(Ulceration);动脉粥样硬化—血栓形成(Thrombosis);动脉粥样硬化—钙盐沉积(Calcification);动脉粥样硬化—动脉瘤(aneurysm);夹层动脉瘤形成(Aorta Dissecting Aneurisms);Summary: 复合病变(complicated lesion);2.主要动脉病变;(2)冠状动脉粥样硬化(Coronary AS );(3)脑动脉粥样硬化Cerebral Vessels AS;Cerebral Infarction (Stroke) ;(4)肾动脉粥样硬化(Renal AS); ●下肢A,股浅A ●间歇跛行 ●足趾干性坏疽 ;●肠梗死: 剧烈腹痛,腹胀,发热,便血,肠梗阻,休克 ;;Advance in etiology pathogenesis of atherosclerosis;Risk Factors;;血流剪应力反应(Shearing stress);;;;;; 高 血 压 (Hypertension) 南方医科大学 基础医学院病理学系 周洁 ;Case Report;Autopsy results; Cerebral Infarction (Stroke) ; What’s hypertension?;Causes of hypertension(HT); Types of primary hypertension(分型) ; 1. 良性高血压 benign (Chronic) hypertension; Stages of Chronic hypertension;Arteriolosclerosis;Stages of Chronic hypertension;正常心脏与高血压心脏(Hypertensive heart disease);Left Ventricular Hypertrophy;b.肾(kidney) 原发性颗粒性固缩肾(essential granular atrophic kidney) Gross morphology 弥漫性对称性缩小，变硬,表面细颗粒状,皮质变薄≤2mm