高血压合并动脉粥样硬化课件.pptx

1、This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller a

2、nd DS18B20 temperature sensor.高血压合并动脉粥样硬化高血压合并动脉粥样硬化患者的优化降压治疗患者的优化降压治疗This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microco

3、mputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.目录目录高血压患者抗动脉粥样硬化治疗至关重要足剂量ACEI有效抗动脉粥样硬化培哚普利8mg全面干预动脉粥样硬化This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and c

4、ontrol by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高血压患者动脉粥样硬化发生率更高高血压患者动脉粥样硬化发生率更高Prevention and Control.2005;1:3-15This paper mainly introduces the design of an int

5、elligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.Pharmacology&Therap

6、eutics 117(2008)354373高血压高血压通过多种途径促进动通过多种途径促进动脉粥样硬化脉粥样硬化进展进展高高 血血 压压血流动力学改变血流动力学改变(剪切力剪切力 )氧化应激氧化应激炎症介质炎症介质内皮功能损伤内皮功能损伤LDL氧化氧化 动脉粥样硬化动脉粥样硬化oxLDL沉积沉积 SMC增殖迁移增殖迁移This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement

7、and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.动脉粥样硬化参与动脉粥样硬化参与心血管疾病的发生发展心血管疾病的发生发展 From J Am Coll Cardiol 2001;37:975-84.病理生理链病理生理链中心动脉压升高中心动脉压升高脉压增大脉压增大动脉僵

8、硬度动脉僵硬度增加增加斑块破裂、血栓形成斑块破裂、血栓形成心梗、心绞痛、卒中等心血管事件心梗、心绞痛、卒中等心血管事件This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The

9、core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.内皮功能紊乱与动脉粥样硬化密切相关内皮功能紊乱与动脉粥样硬化密切相关介导内皮依赖性血管舒张(FMD)颈内膜-中膜厚度(IMT)FMD：是评估内皮功能紊乱的指标；IMT是解剖组织结构测量亚临床动脉粥样硬化的指标P=0.02内皮功能与动脉粥样硬化的关系118例类风湿关节炎患者，无心血管疾病史，且诊断后至少随访一年。评估长期患病(距离疾病诊断的时间7.5-19.7年)内皮功能与动脉粥样硬化的关系C Gonzlez-Juana

10、tey,et al.Arthritis Research&Therapy 2011,13:R101This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core compo

11、nents of the system are AT89C51 microcontroller and DS18B20 temperature sensor.最新最新MESA研究研究动脉粥样硬化显著增加心血管事件风险动脉粥样硬化显著增加心血管事件风险114567010203040506070卒中心血管疾病冠心病p0.001p0.001p=0.59较无动脉粥样硬化的变化(%)Polak JF,et al.J Am Heart Assoc.2013;2:e000087MESA:美国动脉粥样硬化多种族研究6562例年龄61.1 岁受试者，平均随访7.8年，评估超声检查不同程度颈内斑块可预测心血管事件

12、和冠心病事件 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontr

13、oller and DS18B20 temperature sensor.高血压合并心血管危险因素患者高血压合并心血管危险因素患者普遍存在动脉粥样硬化普遍存在动脉粥样硬化 动脉粥样硬化高血压糖尿病血脂异常冠心病慢性肾病Fruchart JC,et al.Circulation.2004;109:III-15-III-19Luczak M,et al.Proteome Science 2011,9:25This paper mainly introduces the design of an intelligent temperature control system which realize

14、s the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.高血压患者中高血压患者中针对动脉粥样硬化的治疗极为重要针对动脉粥样硬化的治疗极为重要Circulation.1991;84(suppl

15、VII:VI-2-VI-16)This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 mi

16、crocontroller and DS18B20 temperature sensor.高血压患者的抗动脉粥样硬化治疗极为重要高血压患者的抗动脉粥样硬化治疗极为重要 无论一级预防，还是二级预防，高血压无论一级预防，还是二级预防，高血压患者治疗的主要目的都是为了患者治疗的主要目的都是为了延缓或逆转潜延缓或逆转潜在的动脉粥样硬化过程。在的动脉粥样硬化过程。AHA防治缺血性心脏病高血压治疗指南防治缺血性心脏病高血压治疗指南(2007)Circulation 2007;115:2761-2788This paper mainly introduces the design of an intelli

17、gent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.目录目录高血压患者抗动脉粥样硬化治疗至关重要足

18、剂量ACEI有效抗动脉粥样硬化培哚普利8mg全面干预动脉粥样硬化This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the syst

19、em are AT89C51 microcontroller and DS18B20 temperature sensor.动脉粥样硬化是一个缓慢进展的过程动脉粥样硬化是一个缓慢进展的过程Jens Lykkesfeldt，et al.J.Pineal Res.2008;44:426431脂质沉积，斑块开始形成斑块进展导致官腔狭窄斑块破裂引起心血管事件内皮损伤This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temp

20、erature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.内皮功能障碍是动脉粥样硬化的起始环节内皮功能障碍是动脉粥样硬化的起始环节Chhabra N,et al.Internet Journal of Medical Update.200

21、9;4(1):33-41This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 micro

22、controller and DS18B20 temperature sensor.RAAS过度激活促进动脉粥样硬化进展过度激活促进动脉粥样硬化进展 2.843.601234高血压高血压+动脉粥样硬化Ang浓度(ng/ml)高血压合并动脉粥样硬化患者较单纯高血压RAAS显著激活David S,et al.Journal of Hypertension 2009,27:16411647Sata M,et al.Inflammation and Regeneration.2011;31(3):245-255Circulation 2007;115:2761-2788氧化应激氧化应激RAAS过度激活

23、过度激活动脉粥样硬化血管内皮血管内皮结构和功能改变结构和功能改变炎症炎症This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the

24、system are AT89C51 microcontroller and DS18B20 temperature sensor.2012荟萃分析：荟萃分析：ACEI/ARB显著降低动脉粥样硬化显著降低动脉粥样硬化性疾病患者硬终点事件性疾病患者硬终点事件(包括血压正常人群包括血压正常人群)McAlister FA,et al.Eur Heart J.2012 Feb;33(4):505-1413项高质量的随机安慰剂对照试验、共80594例患者进行荟萃分析7%CV死亡5%全因死亡17%所有心梗9%所有卒中This paper mainly introduces the design of an

25、 intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.动脉粥样硬化患者斑块组织中AC

26、E高度表达，显著增加患者不稳定性心绞痛的发作，因此，ACEI治疗可有效预防斑块裂隙、血栓形成和破裂Karsten Grote,et al.Nephrol Dial Transplant.2004;19:770-773斑块组织中斑块组织中ACE高度表达高度表达ACEI治疗可有效预防动脉粥样硬化性疾病治疗可有效预防动脉粥样硬化性疾病This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measure

27、ment and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ACEI血管舒张功能显著优于血管舒张功能显著优于ARBSun YP,et al.J Cardiovasc Pharmacol Therapeut.2001;6(2):175-181.This paper mai

28、nly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 tem

29、perature sensor.ACEI显著改善动脉粥样硬化患者血管内皮功能显著改善动脉粥样硬化患者血管内皮功能 血管舒张(%)*P 0.05 vs 未治疗组94*17*-20*77-24-46-60-40-20020406080100120组胺血清素乙酰胆碱ACEI治疗组未治疗组纳入8例动脉粥样硬化患者，评估接受赖诺普利治疗后冠状动脉内皮依赖性因子的变化Tiefenbacher CP,et al.Am J Physiol Heart Circ Physiol.2004;286:H1425H1432 This paper mainly introduces the design of an i

30、ntelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.ACEI显著减少脂质面积，稳定斑块

31、显著减少脂质面积，稳定斑块P=0.001Sun YP,et al.J Cardiovasc Pharmacol Therapeut.2001;6(2):175-181.42只兔给以0.5%的胆固醇喂养，随机给以安慰剂、卡托普利(10mg/kg/d)，群多普利(0.3mg/kg/d)，观察14周对照组卡托普利群多普利This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement an

32、d control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.足剂量足剂量ACEI显著延缓动脉粥样硬化进展显著延缓动脉粥样硬化进展0.0220.0180.014*00.0050.010.0150.020.025安慰剂雷米普利2.5mg/d雷米普利10mg/d颈动脉IMT进展速度(mm/

33、年)Lonn EM,et al.Circulation.2001;103:919-925 P=0.033*P=0.028 vs 安慰剂SECURE研究：732例动脉粥样硬化高危患者(血管疾病、糖尿病、无心衰或低左室射血分数)随机给以安慰剂、雷米普利2.5mg/d、雷米普利10mg/d，平均随访4.5年This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and contr

34、ol by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.目录目录高血压患者抗动脉粥样硬化治疗至关重要足剂量ACEI有效抗动脉粥样硬化培哚普利8mg全面干预动脉粥样硬化This paper mainly introduces the design of an intelligent temper

35、ature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.培培哚普哚普利利8mgP*0.05 对照对照冠心病冠心病-PERTI

36、NENTbaseline1 year01020#p=controls vs baseline;*p=Coversyl vs placeboCeconi C,et al.Cardiovascular Research.2007;73:237246PERTINENT87例冠心病患者，随机接受培哚普利8mg/d或安慰剂治疗，随访1年This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurem

37、ent and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.Ghiadoni L et al.Hypertension.2003;41:1281-1286.FMD(%)7,1P 0.01*6,84,85,15,75,65,65,2*血压正常者血压正常者阿替洛尔阿替洛尔 5

38、0-100mg(n=29)氨氯地平氨氯地平 5-10 mg(n=28)血压正常者血压正常者(n=40)高血压者基线水平高血压者基线水平(n=168)培哚普利培哚普利 4 mg(n=28)硝苯地平硝苯地平 30-60 mg(n=28)Nebivolol 5-10mg(n=28)替米沙坦替米沙坦 80-160mg(n=29)NS高血压者高血压者培哚普利培哚普利硝苯地平硝苯地平氨氯地平氨氯地平阿替洛尔阿替洛尔Nebivolol替米沙坦替米沙坦一项前瞻性、随机、平行分组研究中，在168位高血压患者中检测用药前、用药6个月后的血流介导的、内皮依赖性的血管扩张功能；这些患者被随机分配到硝苯地平组（30-6

39、0 mg,n=28），氨氯地平组（5-10mg，n=28），阿替洛尔 组（50-100mg，n=29），奈必洛尔组（5-10mg，n=28），替米沙坦 组（80-160mg，n=29），培哚普利组（2-4 mg，n=28）。如果需要，每组中可加用氢氯噻嗪（25mg）。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using singl

40、e bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.培哚普培哚普利利8mg显著减少显著减少低低含钙斑块含钙斑块(0-25%)的体积的体积斑块面积的变化斑块面积的变化(mm2)培哚普利 安慰剂*-0.33-0.03PERSPECTIVE斑块钙含量 0-25%的节段Bruining N,et al.Coron Artery D

41、is.2009;20:409-414.P=0.04 纳入118例冠心病患者选出711个5mm长的冠脉断，观察随机给以安慰剂(n=351)和培培哚普利8mg/d(n=360)对冠状动脉粥样硬化斑块进展作用，共随访3年 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature

42、sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.管腔面积平均变化(mm2)钙含量百分比(%):0-25、25-50、50-100培哚普利培哚普利8mg显著延缓管腔狭窄进展显著延缓管腔狭窄进展Bruining N,et al.Coron Artery Dis.2009;20:409-414.PERSPECTIVE 纳入118例冠心病患者选出711个5mm长的冠脉断，观察随

43、机给以安慰剂(n=351)和培培哚普利8mg/d(n=360)对冠状动脉粥样硬化斑块进展作用，共随访3年 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core c

44、omponents of the system are AT89C51 microcontroller and DS18B20 temperature sensor.培哚普利培哚普利8mg抑制动脉粥样硬化血栓形成抑制动脉粥样硬化血栓形成Ceconi C,et al.Atherosclerosis.2009;204;2732750.240.1800.050.10.150.20.25基线1年D-二聚体浓度*(g/mL)P0.05*升高反应了体内存在凝血及纤溶活性增强的重要分子标志物，可反应体内存在血栓或继续形成的状况87例冠心病患者，随机接受培哚普利8mg/d或安慰剂治疗，随访1年This pap

45、er mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B

46、20 temperature sensor.Thybo NK et al.Hypertension.1995;25:474-481.对比之前对比之前*P 0.05.*P 0.01 对比阿替洛尔对比阿替洛尔 iiP 0.01培哚普利培哚普利阿替洛尔阿替洛尔 n=25n=13n=12平均血压(mm Hg)管腔直径(m)90122101*12698*237208247*ii222208P 0.01P 0.05NS血压正常者血压正常者用药前用药前用药前用药前用药后用药后用药后用药后12个月个月动脉中膜动脉中膜-管腔比值管腔比值(%)8645.827.945.967.146.79培哚普培哚普利利8mg8

47、mg逆转逆转小小动脉重构动脉重构 纳入既往血压控制不佳的高血压患者接受培哚普利(n=13，4-8mg/d或阿替洛尔(n=12,50-100 mg/d)，血压控制不佳者可联合利尿剂(培哚普利组5例，阿替洛尔组2例)，治疗12个月This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital tempera

48、ture sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.Kool MJ,et al.J Hypertens.1995;13:839-848.*对比基线对比基线 P 0.05;培哚普利与培哚普利与 HTCZ+阿米洛利之间无统计学意义阿米洛利之间无统计学意义收缩压收缩压(mm Hg)用药前用药前用药前用药前用药后用药后用药后用药后6个月个月HTCZ+阿米洛利阿米洛利156

49、13810394培哚普利培哚普利150135*10493*P 0.0115105颈总动脉可扩张性的改善颈总动脉可扩张性的改善(%)n=41*P 其他其他ACEI最新最新ACEI荟萃分析荟萃分析(30项研究项研究)Cardiovasc J Afr.2009 Mar-Apr;20(2):127-34.*与其他与其他ACEI类药物相比类药物相比，培哚普利显著降低主要终，培哚普利显著降低主要终点事件点事件18%(OR 0.82;95%CI:0.770.88;P 0.0001)。当除去涉及培哚普利的研究当除去涉及培哚普利的研究后再分析发现，主要终点事后再分析发现，主要终点事件的发生率仅降低了件的发生率仅

50、降低了5%(OR 0.95;95%CI:0.910.98;P=0.0039，)。培哚普利培哚普利 其他其他ACEI(不包含培哚普利不包含培哚普利,的依那普利、的依那普利、赖诺普利、雷米普利、喹那普赖诺普利、雷米普利、喹那普利、福辛普利和卡托普利利、福辛普利和卡托普利)P=0.0039P 其他其他ACEIACEI 0 1 2 3 4 5 培哚普利培哚普利 所有所有ACEI(包含培哚普利包含培哚普利).Cardiovasc J Afr.2009 Mar-Apr;20(2):127-34.N=204,000雅施达雅施达所有所有ACEIThis paper mainly introduces the