文档介绍：高血压 (Hypertension) 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) Haemorrhagic Haemorrhagic Necrosis Necrosis What ’ s hypertension? ?在安静休息状态下体循环血压持续增高,收缩压≥140 mmHg 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 mmHg Causes of hypertension(HT) ?原发性( primary HT ) 95% 特发性( Idiopathic HT Idiopathic 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,1-2 y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 difficulties Stages 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>100 mmHg ?左心室轻度肥大 Arteriolosclerosis