20xx年醫(yī)學(xué)專(zhuān)題—糖尿病與腦卒中(編輯修改稿)
2024-11-16 02:59 本頁(yè)面
【文章內(nèi)容簡(jiǎn)介】 ) 58.4 69.2 45.2 性 SBP mmHg 159.7* 150.3 DBP mmHg 94.0* 98.3 91.2 Tc mmol/L 7.2 7.1 6.8 Anti HT Tx(%) 12.6 9.7 6.2 BMI kg/m2 26.4 26.0 26.0 DM (%) 38.3 12.5 4.1 女 Smokers(%) 17.2 18.0 10.9 性 SBP mmHg 158.9 * 153.8 145.0 DBP mmHg 96.8 * 93.6 89.2 Tc mmol/L 6.6 6.7 6.6 Anti HT Tx(%) 26.5 27.1 26.4 BMI kg/m2 27.7 27.1 26.4 Stroke 1996。27:210215,11/14/2024,13,第十三頁(yè)，共三十五頁(yè)。,Endothelial Dysfunction in Diabetes Diabetes Mellitus Hyperglycemia Insulin resistance Excess Free Fatty Acids Oxidative stress Pkc Activation Receptor for Advanced glycation End product (RAGE) Activation,11/14/2024,14,第十四頁(yè)，共三十五頁(yè)。,ENDOTHELIUM ? Nitric Oxide ? Nitric Oxide ?nitric Oxide ? Activation of NFkB ? tissurer factor ?Endothelin1 ? angiotension II ? PAI1 ?Angiotensin II ? Activator of Activator protein1 ? prostacylin Vasconstriction Inflamation Trombosis Hypertesion Release of chemokines Hyperglycemia vascular smooth Release of cytokines platelet activation Muscle cell groth expression of cellular adhesion molecules decreasd fibrinolysis Atherogenesis,11/14/2024,15,第十五頁(yè)，共三十五頁(yè)。,,Antiathetosclerosis Therapy in Diabetes,Dyslipedemia Hypertesion statins FAD ACEI ARB TZD Athrosclerosis Diuretic BB CCB Hyperglycemia Platelet Insulin Resistance and aggregation Ins Mt TZD SU Aspirin NonSu Clopidogrel Secretagogues Ticlopidine,11/14/2024,16,第十六頁(yè)，共三十五頁(yè)。,Medical Therapy of hypertension,Indication Drug mg/d Type FU Event NNT DM and HT Captopril 50100 2 9.0y stroke 27 DM and HT Atenolol 50100 2 9.0y Stroke 27 Dm and HT Captopril 50100 2 9.0y DM related death 20 DM and HT Atenolol 50100 2 9.0y DM related death 20 DM HT LVH Losartan 50100 DM 4.7y Total death 17 DM+1 CVD RF Ramipril 10 DM 4.5y CVD death MI 22 stroke DM+1 CVD RF Ramipril 10 DM 4.5y CVD death, MI 14 Cr1.4mg/dl JAMA 2002。287:25702581,11/14/2024,17,第十七頁(yè)，共三十五頁(yè)。,SystEur結(jié)果顯示 降壓治療(zh236。li225。o)降低 糖尿病患者腦卒中效果更顯著,危險(xiǎn)性下降(xi224。ji224。ng) 糖尿病 非糖尿病 死亡 64 14 心血管
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