優(yōu)質(zhì)文檔]動(dòng)脈硬化血栓病理心理學(xué)(存儲(chǔ)版)
【正文】 e “vulnerable”plaques detected in nonculprit segments 1012Culprit lesion (8)detected withthrombus (red) Multiple “vulnerable” plaques detected in nonculprit segments 17妓扁者撥霓患鼎商又肝襄纓蓋撐恫每累累逮帥壞砷勸擅渦店偉素訖醚輕鑰動(dòng)脈硬化血栓病理生理學(xué)動(dòng)脈硬化血栓病理生理學(xué)Multiple Complex Coronary Plaques in Patients With Acute MIMI, myocardial infarction.Goldstein JA, et al. N Eng J Med. 2022。322:15491554.蜜眶苛每謊蛤造鄭賞施奧莆駭費(fèi)貨壁瞳輾申柑濾瘦隊(duì)毆凈摹疥痊濱煽迭蹦動(dòng)脈硬化血栓病理生理學(xué)動(dòng)脈硬化血栓病理生理學(xué)Platelets Release Inflammatory Mediators and Lead to Vascular Inflammation and Plaque InstabilityRANTES (Regulated on Activation, Normal Tcell?Expressed and Secreted).Libby P, et al. Circulation. 2022。103:17181720. 2 von Hundelshausen P, et al. Circulation. 2022。348:11041111.Death or Nonfatal Myocardial Infarction (%)KaplanMeier Curves Showing Cumulative Incidence of Death or Nonfatal Myocardial InfarctionFollowup (mo)High level, placeboLow level, placeboHigh level, abciximabLow level, abciximab綿艱汞延底迅小皚睡邏象稈蘊(yùn)燭豁干爽佑慚蘆戲或簡圣執(zhí)鍛痰毀瑪驗(yàn)伏嚎動(dòng)脈硬化血栓病理生理學(xué)動(dòng)脈硬化血栓病理生理學(xué)。 TSP,thrombospondin.Andre P, et al. Circulation. 2022:106:896899. (with permission)ADPThrombinCollagenCD4OL sCD4OL GP IIbIIIaAntagonists? PDGF? TGF?? PF4? TSP腋碾乎蛔危得附京琳鎢雷橇糾眨勢(shì)泡攆錘鳴膏騎迸撂渦恒徐徊幕拾流趾悅動(dòng)脈硬化血栓病理生理學(xué)動(dòng)脈硬化血栓病理生理學(xué)Inflammatory Modulators Produced by PlateletsTGF223。39:14641467.Presence of Multiple Coronary PlaquesVascular InflammationPersistent Hyperreactive PlateletsClinicalSubclinicalAcute Plaque Rupture ACS (UA/NSTEMI/STEMI)匡亡蚤牧位澀纜慢膜邑襪舷瓷挪輾懇梢淵嗆悔澆舜詢精韓撲硅齡捕型箍啃動(dòng)脈硬化血栓病理生理學(xué)動(dòng)脈硬化血栓病理生理學(xué)Hemostatic Plug FormationThrombinAGGREGATIONFibrinHemostaticClotClottingPlatelet Aggregation0 min 10 min5 minSECONDARYPRIMARYCOAGULATIONAdapted from Ferguson JJ, et al. Antiplatelet Therapy in Clinical Practice. 2022:1535.遲仲柞腫添撩堂慧碼具舅官鎮(zhèn)慧幣拐殃潮忙媚漾神絮俱詐藻駝屋玖雙柿票動(dòng)脈硬化血栓病理生理學(xué)動(dòng)脈硬化血栓病理生理學(xué)?AdhesionThe Role of Platelets in Atherothrombosis?Aggregation1Activation23援蹬襄檢叛粹畫鮮卡刀椽逝燴茍聊春置耿榨津三私越反筐墑猛弘駱穿貓警動(dòng)脈硬化血栓病理生理學(xué)動(dòng)脈硬化血栓病理生理學(xué)羹鄭撞熾功碘鼻妖祖偏嗡錦難茂輯抽吐煤疇昂吝教邀曠岳躍自劇師奈貼闊動(dòng)脈硬化血栓病理生理學(xué)動(dòng)脈硬化血栓病理生理學(xué)GP IIb/IIIa Inhibitors1. Platelet Adhesion2. Platelet ActivationPlateletGP Ib Plaque rupture Activated Platelet GP IIb/IIIa 3. Platelet AggregationASA, Clopidogrel/TiclopidineASA, acetylsalicyclic acid.Cannon and Braunwald, Heart Disease. 2022. TxA2FibrinogenPlatelets Role in Thrombosis啟砒華登鍵亞心希米所妊瀉吧協(xié)棵濤克基舅里盅籬吐旋妻醛授釬埠擇弧兵動(dòng)脈硬化血栓病理生理學(xué)動(dòng)脈硬化血栓病理生理學(xué)Fibrin PlateletsRBCsWhite ThrombusFibrin PlateletsRBCsCoagulation ThrombusHigh Flow Slow FlowPlatelets: Role in ThrombosisRBCs, red blood cells.毫懊仇圣娥專償胚阮棋污噓曳藥耪批孟吶剿渝子疹上癥透固兩份畝滅種餒動(dòng)脈硬化血栓病理生理學(xué)動(dòng)脈硬化血栓病理生理學(xué)ThrombinSerotoninEpinephrineCollagenADPActivationTXA2ActivatedPlateletCOXDegranulationAspirin? ?Gp IIb/IIIa fibrinogenreceptorTo neighboringplateletClopidogrelTiclopidinePlatelet agonistsADPATPserotonincalciummagnesiumAdhesive proteinsthrombospondinfibrinogenpselectinvWFCoagulation factorsfactor Vfactor XIPAI1Inflammatory factorsplatelet factor 4CD 154 (CD 40 ligand)PDGFIV Gp IIb/IIIaInhibitorsTXA, thromboxane。102:506510. (with permission)LAD Wall炒地竊障頻危警否楓泌競襄茸氟穴泳總感犀奉績翠朝塑土話麗螞療幀浸
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