高血压、心肌病、心肌炎.ppt

高血压(Hypertension) 南方医科大学基础医学院病理学系周洁Case Report张某,男,62岁,突然昏迷2小时入院。10年前发现高血压,近来常感心悸,以体力活动为甚,近半月觉头晕、眼花、乏力,四肢麻木,今晨上厕所时突然跌倒,不省人事,左侧上下肢不能活动并有小便失禁。给予吸氧、降压等治疗,疗效不显,昏迷加深,呼吸不规则,呼吸心跳停止死亡。Autopsy results Cerebral Infarction (Stroke) ecrosisNecrosis What’s hypertension??在安静休息状态下体循环血压持续增高,收缩压≥140mmHg和/或舒张压≥90mmHg?Hypertension is elevated levels of blood pressure(High Blood Pressure)?Sustained increase in blood pressure. Systolic ≥ 140, Diastolic ≥ 90 mmHgCauses of hypertension(HT)?原发性(primary HT) 95% 特发性(Idiopathic HTIdiopathic HT) 高血压病?继发性(secondary HT) 5% 症状性(symptomatic HT) Types of primary hypertension(分型) ?良性(benign) 缓进型(Chronic)95-98%?恶性(malignant)急进型(Accelerated) 2-5%,进展迅速, 病变严重,1-2y死亡 1. 良性高血压benign (Chronic) hypertension(1)机能紊乱期(functional phase)细小A痉挛(spasm)→血压波动?无器质性变化(an damage)?dizziness, headache, and visual difficultiesStages of Chronic hypertension (2)动脉系统病变期 (arteries change phase)?细A(<1mm)玻璃变→细A硬化(Arteriolosclerosis)?肌型A内膜胶原弹力纤维增生,内弹力膜分裂→中膜增厚,管腔狭窄?BP持续增高, 舒张压>100mmHg?左心室轻度肥大Arteriolosclerosis