当前课程知识点:Gateway to Medicine: An Introduction to the Field of Medicine > CH06 Cardiovascular disease (Atherosclerosis and hypertension) > 08 The types and pathologic changes of essential hypertension > The types and pathologic changes of essential hypertension
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原发性高血压的类型与病理变化
良性高血压进展慢
又称缓进性高血压
恶性高血压进展快
故又称急进性高血压
我们通常讲的高血压
指的就是良性高血压
良性高血压的病理变化
根据其病理变化的过程
可以分为三个时期
第一 机能紊乱期
第二 动脉病变期
第三 内脏病变期
具体表现
一 机能紊乱期
表现是全身细小动脉痉挛
那么这时候病人
是血管处在紧张的状态
血压可以增高
但是经过休息
它可以恢复
因此血压是有所波动的
而全身的血管
尤其细小动脉
没有出现器质性的变化
第二 动脉病变期
由于内皮受损使得血浆蛋白
沉积到血管内膜下
而引起细小动脉硬化
它主要是由于
血管长期的痉挛
使得内皮细胞缺氧
内皮细胞受损而使得血浆蛋白
沉积到内膜下
导致细小动脉的硬化
三 内脏病变期
主要表现在心 脑 肾
心脏由于外走循环阻力增高
而使心肌肥大
而引起高血压心脏病
早期表现的是代偿性的心肌肥大
后期失代偿表现是
远心性的心肌肥大
肾
表现肾小球入球小动脉硬化
致使相应的肾小球缺血萎缩
纤维化
而引起原发性的细颗粒固缩肾
脑
出现脑水肿 脑软化
脑出血等高血压脑病
高血压脑病可以表现为是
脑软化 脑出血和脑水肿
现在我们这里看到的就是一个
脑出血
常常发生在内囊附近
急进型高血压的病理变化
病变表现一
坏死性细动脉炎
细动脉发生纤维素样坏死
形成的机制主要是
免疫复合物沉积于血管壁
而引发的变态反应
二
增生性小动脉炎
和闭塞性的小动脉炎
是在坏死性小动脉炎的上边
血管的疤痕修复
而导致纤维组织增生
形成的增生性血管炎
致使小血管完全闭塞
表现为是闭塞性的小动脉炎
这时候
小动脉的横截面
出现葱皮一样的结构
累及部位主要有肾小球动脉
肾小叶间动脉
脑小动脉
起病急骤 临床进展快
心 脑 肾病变发生早
多见于中青年
与良性高血压无关
某些病人伴有良性高血压
是因为病人在发病前
本身已经患有良性高血压
-01-The basic condition of the air
--The basic condition of the air
-02-What is smog and its influence to the body
--What is smog and its influence to the body
-03-The structure and the function of human respiratory system
--The structure and the function of human respiratory system
-04-How the smog cause the human respiratory system disease
--How the smog cause the human respiratory system disease
-05-Asthma
--Asthma
-Exercise 01
-06-COPD
--COPD
-07-Lung cancer Ⅰ
-08-Lung cancer Ⅱ
-Exercise 02
-01 Dissection of genital organs
--Dissection of genital organs
-Exercise 01
-02 The formation of embryo and fetal appendage
--The formation of embryo and fetal appendage
-Exercise 02
-03 Characteristic of embryonic and fetal development
--Characteristic of embryonic and fetal development
-04 Maternal changes during pregnancy
--Maternal changes during pregnancy
-05 Four factors that affect childbirth
--Four factors that affect childbirth
-06 Mechanism of labor
-01 The energy requirement and the metabolic characteristics of kids
--The energy requirement and the metabolic characteristics of kids
-02 Need of the nutrition and metabolism of kids Ⅰ
--Need of the nutrition and metabolism of kids Ⅰ
-Exercise 01
-03 Need of the nutrition and metabolism of kids Ⅱ
--Need of the nutrition and metabolism of kids Ⅱ
-Exercise 02
-04 Guided feeding of infant Ⅰ
-Exercise 03
-05 Guided feeding of infant Ⅱ
-06 Guided feeding of infant Ⅲ
-01 Introduction
-02 What is tumor
-03 The general shape of tumor
-04 The atypia of the tumor
-05 Name and classification of the tumor
--Name and classification of the tumor
-Exercise 01
-06 The growing type of the tumor
--The growing type of the tumor
-07 Spread of tumor
-Exercise 02
-08 The grading and staging of tumors and the effects to the body
--The grading and staging of tumors and the effects to the body
-09 The difference between benign and malignant tumors
--The difference between benign and malignant tumors
-10 The environmental causes of cancer
--The environmental causes of cancer
-11 Heredity and tumor
-01 Overview
--Overview
-02 Sudden cardiac arrest
-Exercise 01
-03 Non-professional life support
--Non-professional life support
-Exercise 02
-04 Professional life support
-Exercise 03
-05 Adult advanced life support Ⅰ
--Adult advanced life support Ⅰ
-Exercise 04
-06 Adult advanced life support Ⅱ
--Adult advanced life support Ⅱ
-Exercise 05
-07 Electric defibrillation
-01 Introduction
-02 Risk factors and pathogenesis of atherosclerosis
--Risk factors and pathogenesis of atherosclerosis
-03 Pathological changes of atherosclerosis
--Pathological changes of atherosclerosis
-Exercise 01
-04 Atherosclerosis of vital organs
--Atherosclerosis of vital organs
-05 Coronary atherosclerotic heart disease
--Coronary atherosclerotic heart disease
-Tips 03
--Tips 03
-06 Primary hypertension
-Exercise 02
-07 The etiology and pathogenesis of hypertension
--The etiology and pathogenesis of hypertension
-08 The types and pathologic changes of essential hypertension
--The types and pathologic changes of essential hypertension
-Exercise 03
-01 Overview Ⅰ
-02 Overview Ⅱ
-03 What is virus
-Exercise 01
-04 The structure and functions of influenza viruses
--The structure and functions of influenza viruses
-Exercise 02
-05 Different type of influenza viruses
--Different type of influenza viruses
-Exercise 03
-06 Bird flu
--Bird flu
-Exercise 04
-07 Street virus
-Exercie 05
-01 Introduction
-02 Chronic gastritis caused by helicobacter pylori infection
--Chronic gastritis caused by helicobacter pylori infection
-Exercise 01
-03 Helicobacter pylori causes peptic ulcer
--Helicobacter pylori causes peptic ulcer
-Exercise 02
-04 Pathological changes of peptic ulcer
--Pathological changes of peptic ulcer
-Exercise 03
-05 Gastric cancer
-01 The evolution of biological motion
--The evolution of biological motion
-02 Biomechanics of human motion
--Biomechanics of human motion
-Exercise 01
-03 The perfect unity of function and structure
--The perfect unity of function and structure
-Exercise 02
-04 A brief history of trauma orthopedic development Ⅰ
--A brief history of trauma orthopedic development Ⅰ
-05 A brief history of trauma orthopedic development Ⅱ
--A brief history of trauma orthopedic development Ⅱ
-Exercise 03
-06 Sprain and fracture of the ankle joint
--Sprain and fracture of the ankle joint
-Exercise 04
-07 Ankle sprain
-Exercise 05
-08 Prevention of ankle sprain
-Final Exam