340 likes | 473 Views
??????????. ???????,????????????????2007???271.6?????????,?????????34%,???11.6???1?,???????????3?(?34???1?),????10??????????!??2002???????5684??,2007????10966??,5??????. 2008??????????. ?????????????. ??????????(vulnerable plaque)???????????????(ACS)??????????????????????????????????????????????????????????(thin-cap fibroatheroma, TCFA).
E N D
1. ??????????????????????
????????
? ?
3. ????????????? ??????????(vulnerable plaque)???????????????(ACS)???????
???????????????????????????
????????????????????????(thin-cap fibroatheroma, TCFA)
4. ACS?????
5. Thin-Cap FibroAtheroma
6. ??????? ????????(>40% ????)
????? (<65µm)
????????T???????????
????????????????
??????
??????
????
7. vulnerable plaque
8. ????????? ??-????
??-????
????-??
??????
????????
????????
9. ??????
10. ??????
11. ?????????????? ??????????????,???????
???????????P4Ha(I)?????TNF-a????,??NonO????????
??????SiRNA??NonO??,TNF-a?????P4Ha(1)??????70%,??????ASK1-JNK?????
?????????????????????????????
12. ??????????????
13. ??—????
14. ??? ? J Cell Physiol, 2010, Published Online May 27 2010 ??? ? J Cell Physiol, 2010, Published Online May 27 2010
15. ??—????
19. ??????????? ????????????????,?????????(AF)???????????
??Smad, MAPK ???????????????AF?????????
???????????(Gax)????????????????AF???
20. ????????? ???????????????????????????,???????????????
??????????????????,????????????????
22. ??????? ???????
??????
?????
CT??
?????
??????
?????
????????
????????
23. ???????
24. ??????????????????
26. ?????????????????? ??????????????????????????????
????????????????????
27. ????????????????
28. Prediction of Plaque Rupture by VVI
29. Prediction of Plaque Rupture by VVI Binary logistic regression model
Strain HR 95%CI p
LSp (%) 0.386 0.1454~0.820 0.007
CSp (%) 8.446 5.904~9.104 0.001
RSp (%) 8.963 5.358~10.486 0.001
30. Prediction of Plaque Rupture by VVI CSp:
Cut-off: 0.268%
Sensitivity: 88.6%
Specificity: 92.0%
AUC: 0.965
RSp:
Cut-off: 0.296%
Sensitivity: 88.0%
Specificity: 88.6%
AUC: 0.963
31. ????????
32. CT????????? ??????
?????,???????????,??CT?<50 HU
?????????,??????????
???????????
CT????
???????????????
????????????CT??????,??????????????????
33. MRI????????? ??????
??????:T2WI??????
?????????
????????:?????????,????????????????
MRI????
??????????????????????????????,?????????????????????????
??????????????
34. ????????????? ??????
????:????????????????,?????????
AMI?????????????,?????????
????????
?????????????????????????
?????????“????”???AS??
???AS?????????????,????????????????
35. IVUS????????? ??????
????????????
???????
????????????,?????????,?????????
IVUS????
???????????
?????????
36. ?????IVUS??
37. ??????????
38. ???????????????
39. OCT????????? OCT???
??????<65µm??????????????100%
?????????????????????????
????????????????
?????????????????????
40. OCT????????? ??????
????????????????????????
??????????
????????????
OCT????
???OCT???????????,????????????????????,??????????, ???OCT??????
????????
41. ???????????
45. ?????????? ?????????
?????????
?????????
?????????
46. ?????????? ???????
?????
ACEI?ARB
ß?????
??????
??????
????
47. ??????? ?????
?????
?????
?????
????
????
????
48. ????? ????LDL-C??,???????????????????????????????????????????
?????????????????,????????????
??????????????????,?????????????
?????????,???????
50. RAS??? ACEI?ARB??????????AS??????
????
??????????????ACEI?ARB??????,???????????????????????
???????????AS???????
LVEF???????,?????????????????????????????????????????,??ACEI???????
51. RAS??? ACEI?ARB??ACS????????????
???????
AMI??24h??????(????????????????????????)
AMI??24h????????????????????????????
??????????????????
53. ß?????????? ß????????????,??????
?????????,????????
????????????????????ß????????????,????ß???
ß????????????????????
54. ?????? ????????????????????????????????????????
??????????????????????
??????????????????
??????????????????????
55. ?????? ???????,?????????????????????>70%????????????,???????????
???????????,???????????????????????????????
56. ?????????????
57. MCP-1???????????
63. Effects of Chinese Medicine TXL Incidence of Plaque Rupture
Group A 73.3% (11/15)
Group D1 14.3% (2/14)
Group D2 7.1% (1/14)
Group D3 7.7% (1/13)
Group E 7.1% (1/14)
(Bars = 20µm)
64. Effects of TXL on Plaques
65. AS??????????????ACS???????
??—??????????????
?????????????????????
??????????ACEI?ARB? ß???????????????????????????????,??????????