脂代谢紊乱与动脉粥样硬化PPT课件.ppt

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1、Cardiovasculardiseaseistheleadingcauseofdeathamongadultsworldwide(1996)Coronarydisease7.2millionCancer6.3Cerebrovasculardisease4.6Acutelowerrespiratorytractinfections3.9Tuberculosis3.0COPD(chronicobstructivepulmonarydisease)2.9Diarrhea(includingdysentery)2

2、.5Malaria2.1AIDS1.5HepatitisB1.2Coronarymortality:alarmingworldwideforecastsAtherosclerosis:amultifactorialdiseaseMainriskfactorsforcoronaryheartdiseaseGlobalprojectionsforthediabetesepidemic:1995-2010AtherosclerosisArterialwall:structureandfunctionDifferen

3、tstagesofatheroscleroticplaquedevelopmentVascularendotheliummodificationinatherosclerosisPlaqueformation1—FattystreakPlaqueformation2—FibrouscapPlaqueformation3—LipidcoreFromplaquetothrombosis,keyevent:plaqueruptureLipidcoreconstitutionActivatedmacrophage

4、saccumulatelipidsLipidcoreconstitutionLDLoxidationParietalvascularinflammationTheactivatedmacrophageproducesinflammatorycytokinesParietalvascularinflammationNFkBactionintheinflammationprocessDiabetesandatherosclerosisTobaccoandatherosclerosisDyslipidemiaand

5、atherosclerosisHTN,hemodynamicfactorandatheroclerosisHowtoreduceplaqueformationInterventiononriskfactorsHowtoreducetheriskofplaqueruptureHowtoreducetheriskofthrombosis~10%Weightloss=~30%VisceraladiposetissuelossCharacteristicsofanunstableplaquePlaquevulner

6、abilityfactorsIntrinsicfactorsModificationofextrinsicvulnerabilityfactorsPlaqueruptureThemainreleasingfactorsClassificationoflipidsandlipoproteinsCharacteristicsoflipoproteinsTriglyceride-richlipoproteins:size,structureandcompositionDigestionandmetabolismof

7、dietaryfatHDLmetabolismandreversecholesteroltransportCholesteroleffluxandreversecholesteroltransportismodulatedbytworeceptorsAtherogenicityofsmalldenseLDLSizeandapolipoproteincompositionarethemainfactorsdeterminingatherogenicityoftriglyceride-richparticles

8、Sizeandapolipoproteincompositionarethemainfactorsdeterminingatherogenicityoftriglyceride-richparticlesApoC-IIImodulatesVLDLApoC-IIIinapoBparticlesisatherogenicRelationshipbetweenapoC-IIIinapoBcontaini