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流行病学研究已经明确了高血压会增加脑血管疾病(不论是脑出血或脑梗塞)的发病率。在严重高血压病人,用药物治疗降压能降低以往无脑血管症状病人的中风发生率,对已患中风而存活者也能减少再次中风的机会。这些情况有力地说明高血压本身能损坏血管,引起中风。慢性高血压导致脑部病损的特异性动脉病变主要在小的阻力动脉。这些病损的病理特征(见到微型动脉瘤,血管壁内纤维素和脂质)及这些病损在脑内的分布部位均提示它们起源于机械性扩张。作者假设的机械扩张学说的病理演变过程是这样的:高血压时,脑子要维持正常的脑血流必需增
Epidemiological studies have identified that hypertension increases the incidence of cerebrovascular disease (whether it is cerebral hemorrhage or cerebral infarction). In patients with severe hypertension, treatment with antihypertensive drugs can reduce the incidence of stroke in patients with previous cerebrovascular symptoms, survivors who have suffered a stroke and reduce the chance of a second stroke. These conditions strongly suggest that high blood pressure itself can damage blood vessels and cause stroke. Specific arterial lesions that cause chronic brain damage in chronic hypertension are predominantly in small resistance arteries. The pathological features of these lesions (see Miniature Aneurysms, Cellulose and Lipids in the Vessel Wall) and the distribution of these lesions in the brain suggest that they all originate from mechanical expansion. The authors hypothesize that the pathological evolution of the mechanistic dilatory doctrine is such that high blood pressure is required in the brain to maintain normal cerebral blood flow