因果转换和AS的形成

Change of Effect into cause and the Study of Formation of Atherosclercsis

本文遵循疾病过程中的因果转换规律和相对阶段姓，提出动脉粥样硬化（ＡＳ），是一个由原始病因和继发病因所组成的多因性疾病，认为ＡＳ一旦被原始病因启动，则与病变互为因果，推动着疾病的发生、发展和形成，三阶段新老病变互相重叠，表现了疾病阶段的相对性。在发生阶段是原始病因造就了脂质代谢紊乱和动脉管壁损伤两原始病理结果，前者是ＡＳ特异性的物质基础，后者是ＡＳ的管壁发病环境，两者缺一不可。随着病程进展，原始结果又转换为下一阶段的继发病因，二因协同，引发出三种病理现象，即脂质向损伤内膜病理性入侵、沉积；血小板在损伤内膜面上的粘聚、释放和血栓形成；平滑肌细胞的增殖、移行和分泌，三者不仅推动了ＡＳ的发展，同时又是第三阶段中脂滴、脂纹和纤维粥斑等病变产生的直接原因。病变反复发生，结果逐渐导致动脉管壁增厚、管腔狭窄、闭塞或破裂出血……完成了ＡＳ的全过程，并在临床上出现一组相应器官或组织的缺血性或出血坏死性的临床综合征。

AbstractIt is suggested that atherosclerosis(AS)is a multiple causes disease. The study followed the regularity of change of effect into cause and the characteristics of dis-ease development stage by stage,It is suggested,that once the disease is initiated by the primitive disease cause,the effect(pathologic change)will become disease for the next stage. Thus the disease will be promoted in the three stages:occurrence,development and formation.New and old pathologic changes overlap with eaec other in the three stages,which shows the relativeness of disease stages.In the first stage of occurrence, it is the primitive disease cause,which results in the two pathologic effects of lipid metafolic disorder and injury of artery vessel wall, The for-mer effect is the material basis of AS specificity,while the latter one is the environment of occurence of vessel wall disease.It is impossible to have only one of them. The primitive effects change into the secondary causes of the disease. The synergy of two causes initiate three patholog-ic phenomena:the patbolotic invasion of lipid into the in- jurcd internal membrane,sedimentation, the adhesion and accumulation of blood platelets on the surface of the in-jured internal mcmbrane,as well as the release of blood platelets and the formation of thrombus.Ther three of proliferation of the cells of smooth muscles, migration and secretion not only promote the progress of AS,but also consist of the direct causes of the pathologic changes,such as lipid pathologic changes result in the gradual increase of the artery wall thickness,stenosis of lumen,or rupture and bleeding…,and thus complete the entire course of AS.And chinically,a clinical syndrme of ischemia or bleed-ing necrosis of a set of corresponding organs or organiza-tions show up.