1、 Update of Prevention and TTT of AS-ACS-SCD 2005-9-12 Xian 冠心病-动脉粥样硬化发病机制及其防治西安交通大学环境与疾病相关基因教育部重点实验室离子通道病研究室西安交通大学医学院第一附属医院心脏内科 心脏电生理和介入心脏病学研究室崔长琮2005-6-17北京 -7-9福州 8-20石河子 2005-9-12 西安动脉粥样硬化-冠心病-脑卒中的发病机制脂代谢紊乱学说-19731994 HDL-LDL 阴阳平衡失调 内皮功能障碍学说-19932005 NO-ET凝血-血管舒缩 阴阳平衡失调 慢性炎症学说-19992005 炎症-抗炎症自主神经
2、 阴阳平衡失调 Update of Prevention and TTT of AS-ACS-SCD 2005-6-17 Beijing AS StrokeCHD-ACSHypertentionChronic HFDMSCD Rf 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 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(2.5) 平衡 HDL
3、3.1mmol/L 高 TG 1.7mmol/L 高TC 5.6mmol/L 高ET cell 102:670-676; Colome C et al. Atherosclerosis 2000;149:295-302; Cockerill GW et al. Arterioscler Thromb Vasc Biol 1995;15:1987-1994.HDLLDLChylomicrons,VLDL, and their catabolic remnants 30 nm 2022 nmPotentially proinflammatory915 nmPotentially anti- inf
4、lammatoryLDLLDLMiyazaki A et al. Biochim Biophys Acta 1992;1126:73-80.EndotheliumVessel LumenMonocyteModified LDLMacrophageMCP-1AdhesionMoleculesCytokinesHDL Prevent Formation of Foam Cells-1IntimaHDL Promote Cholesterol EffluxFoam CellLDLLDLMackness MI et al. Biochem J 1993;294:829-834.EndotheliumV
5、essel LumenMonocyteModified LDLMacrophageMCP-1AdhesionMoleculesCytokinesHDL Inhibit the Oxidative Modification of LDL-2Foam CellHDL Promote Cholesterol Efflux IntimaHDL InhibitOxidationof LDLLDLLDLCockerill GW et al. Arterioscler Thromb Vasc Biol 1995;15:1987-1994.EndotheliumVessel LumenMonocyteModified LDLMacrophageMCP-1AdhesionMoleculesCytokinesInhibition of Adhesion Molecules-3IntimaHDL InhibitOxidationof LDLHDL Inhibit Adhesion Molecule ExpressionFoam CellHDL Promote Cholesterol Efflux
