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1、AtherothrombosisPathophysiologyWhatIsAtherothrombosis?Theformationofathrombusonanexisting atheroscleroticplaqueAtherothrombosisisanewtermrecognizingthatatherosclerosis(plaquedevelopment)andacutethrombosisareintegrallyrelatedtothepresentationofvasculareventsAgeneralized
2、progressivediseaseoflarge-and mid-sizearteriesthataffectsmultiplevascularbeds,includingcerebral,coronary,andperipheralarteriesTheunderlyingdiseaseleadingtomyocardialinfarction(MI),peripheralarterialdisease(PAD),ischemiaandmanyformsofstrokeMI,myocardialinfarction;PAD,pe
3、ripheralarterydisease.FusterV,etal.VascMed.1998;3:231-239.RauchU,etal.AnnInternMed.2001;134:122-238.Atherothrombosis*isthe LeadingCauseofDeathWorldwide1*Atherothrombosisdefinedasischemicheartdiseaseandcerebrovasculardisease.1TheWorldHealthReport2001.Geneva.WHO.2001.22.
4、319.312.69.796.3051015202530Atherothrombosis*InfectiousDiseaseCancerInjuriesPulmonaryDiseaseAIDSCausesofMortality(%)AtherothrombosisSignificantly ShortensLifeAnalysisofdatafromtheFraminghamHeartStudy.PeetersA,etal.EurHeartJ.2002;23:458-466.Atherothrombosisreduceslifeex
5、pectancybyaround 8-12yearsinpatientsagedover60years1AverageRemainingLifeExpectancyatAge60(Men)048121620HealthyYearsHistoryofAMI-9.2yearsHistoryofCardiovascularDisease-7.4yearsHistoryofStroke-12years3.2MillionHospitalAdmissionsCoronaryAtherosclerosisAcuteMyocardialInfar
6、ction1,153,000Admissions829,000 AdmissionsHospitalizationsintheUS DuetoVascularDiseaseCerebrovascularDisease961,000AdmissionsVascularDiseaseOtherIschemic HeartDisease280,000AdmissionsPopovicJR,HallMJ.AdvanceData.2001;319:1-20.PreventableDeathsApproximately57,000deathsc
7、ouldbeavoidedeachyear intheUSifpatientsweregivenappropriatecare.NationalCommitteeforQualityAssurance.Washington,DC2003.700Cervical-cancerscreeningPrenatalcare-blockertreatmentBreast-cancerscreeningSmokingcessationCholesterolmanagementDiabetescareHigh-bloodpressurecont
8、rol1500170025002700650013,60028,300*BasedondatafromtheARICstudyoftheNationalHeart,Lung,andBloodInstitute,1987-1994.In
