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題 名 | 心臟血管疾病預防之最新觀念=New Preventive Concepts of Cardiovascular Disease |
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作 者 | 林廷燦; |
書刊名 | 內科學誌 |
卷 期 | 12:2 2001.04[民90.04] |
頁 次 | 頁62-78 |
分類號 | 415.3 |
關鍵詞 | 動脈硬化; 自由基理論; 內皮受傷; 腎素-血管收縮素系統; 精胺酸; Atherosclerosis; Free radical theory; Endothelial injury; Rennin-angiotensin system; L-arginine; |
語 文 | 中文(Chinese) |
中文摘要 | 心臟血管疾病是世界上最嚴重的健康問題之一,然而隨著分子醫學之日益進展以 及一氧化氮機轉之發現,我們對於心臟血管疾病之基本機制及動脈硬化進展更加瞭解,對於 自由基理論,內皮受傷理論,以及血管生理病理學更成為眾多研究的焦點。有關疾病下血管 內皮、血管中層和動脈外膜之研究,我們確信血管不只是導管而已,在血流之調節和功能方 面,也扮演相當重要的角色。目前的新觀念是:全身血管的內皮細胞暨功能將成為治療和預 防病理過程之標的。因為它們漸漸地被認為和心臟血管疾病有關。對於血管內皮多重角色之 瞭解,導致血管健康觀念之形成。我們認為:恢復血管內皮細胞之正常、將可預防臨床心臟 血管疾病之進展。到目前為止,改變生活習慣如戒煙和運動、飲食習慣之調理包括新的健康 飲料 (葡萄原汁 ) 加上規律性有氣運動習慣之養成。藥物治療如 HMG-COA 還原�t抑制劑和 血管收縮素轉化媒抑制劑、雌激素補充療法、補充飲食中之抗氧化物、以及 L- 精胺酸、葉 酸、包括體內重金屬之袪除或清除身體過多之自由基之觀念、以及荷爾蒙療法,皆可改善血 管內皮細胞之功能,進而預防動脈硬化瘢惡化、因此我們將目前最新文獻暨臨床經驗整理於 后,提供醫界同仁做參考。 |
英文摘要 | Cardiovascular disease is one of the most important health problems all over the world. Its molecular and physiological secrets are step by step beingh discovered. Although their manifestations diverstified, new novel therapeutic strategies will gradually take over and attack new target. in the last decade, significant advances have occurred in our understanding of the presence and nature of endothelial dysfunction in a number of cardiovascular conditions including atherosclerosis and hypertension. Regarding free radical concept and endothelial injury concepty as wll as rennin-angiotensin system (RAS) , endothelium-derived nitric oxide (NO) is now recognized as an important mediator of endothelium-dependent vascular relaxation, and a defect in the NO system- decreased synthesis and/or release of NO by endothelial cells-is currently known to be the basic mechanisms for all cardiovascular disorders. Considering endothelium, medial layer, and advantitial layer in the diseased status, we believed that blood vessel is not to be conduit only. On the contrary, endothelial system plays the very important roles not only in the regulation of blood flow but also in the maintenance of normal vascular homeostatic status. Continued research targeted at the identification of the precise mechanisms responsible for endothelial dysfunction will lead to the development of novel therapeutic approach to reduce the vascular complications associated with the atherosclerotic process. Currently, life style modification such as smoking cessation and regular exercise, together with high fiber and low fat balanced diet will enhance and maintain vascular health. Lipid-lower agents and angiotension converting enzyme inhibitors or angiotensin Ⅱ blocker also improved endothelium function. Moreover, antioxidant supplements together with L-arginine, folic acid and hormone therapy will enhance vascular endothelial function by way of combating free radical and endothelial injury to prevent atherosclerotic progression. Thus, we raised new vascular preventive strategies to maintain vascular health based on our experiences and recent literatures reviews. We hope that this review article will help us to understand update stategies in the field of preventive cardiology and vascular biology. |