Matkovics András
Gyógy-ITT Bt., Felnótt Háziorvosi Rendeló.
Orv Hetil. 2003 Mar 9;144(10):475-81.
Recent data on the pathogenesis of atherosclerosis have revealed various mechanisms damaging the vessel wall by the reactive oxidative substances, mainly by the oxidised LDL, which lead to an inflammation process, resulting in the thickening of the arterial wall and atherosclerotic plaque formation. In these events the oxidative free radicals exert a lot of harmful effects: by the further oxidation of lipids, activation of smooth cells and macrophages, inducing apoptosis and necrosis of endothelial cells. These mechanisms can be blocked by some drugs at several points as listed in the paper. The results of observational studies and clinical trials by vitamin E, angiotensin convertase enzyme inhibitors, angiotensin type-1 receptor blockers, calcium channel blockers and statin treatment are reviewed and evaluated. Possibilities of appropriate antioxidant substitution modes are put forward. Achievements in the regression of atherosclerotic plaques are discussed, since these therapeutic modalities render atherosclerosis a treatable disease.
近期关于动脉粥样硬化发病机制的数据揭示了多种由活性氧化物质，主要是氧化型低密度脂蛋白（ox-LDL）破坏血管壁的机制，这些机制会引发炎症过程，导致动脉壁增厚和动脉粥样硬化斑块形成。在这些过程中，氧化自由基会产生许多有害影响：通过进一步氧化脂质、激活平滑肌细胞和巨噬细胞、诱导内皮细胞凋亡和坏死。如本文所述，这些机制可在多个环节被某些药物阻断。本文对维生素E、血管紧张素转换酶抑制剂、血管紧张素1型受体阻滞剂、钙通道阻滞剂和他汀类药物治疗的观察性研究及临床试验结果进行了综述和评估。提出了合适的抗氧化剂替代模式的可能性。文中还讨论了动脉粥样硬化斑块消退方面的成果，因为这些治疗方式使动脉粥样硬化成为一种可治疗的疾病。
