Rattazzi Marcello, Puato Massimo, Faggin Elisabetta, Bertipaglia Barbara, Zambon Alberto, Pauletto Paolo
Dipartimento di Medicina Clinica e Sperimentale, Università di Padova, Italy.
J Hypertens. 2003 Oct;21(10):1787-803. doi: 10.1097/00004872-200310000-00002.
Recent advances in basic science have shown that atherosclerosis should be considered as a chronic inflammatory process, and that a pivotal role of inflammation is evident from initiation through progression and complication of atherosclerosis. In the past few years many studies have examined the potential for biochemical markers of inflammation to act as predictors of coronary heart disease (CHD) risk in a variety of clinical settings. Several large, prospective epidemiological studies have shown consistently that C-reactive protein (CRP) and interleukin-6 (IL-6) plasma levels are strong independent predictors of risk of future cardiovascular events, both in patients with a history of CHD and in apparently healthy subjects. These molecules could be useful to complement traditional risk factors, as well as to identify new categories of subjects prone to atherosclerosis development. An intriguing question is whether these inflammatory molecules simply represent sensitive markers of systemic inflammation or if they actively contribute to atherosclerotic lesion formation and instability. In this paper we will review the evidence concerning the cardiovascular prognostic value and the potential direct involvement of CRP and IL-6 in atherogenesis.
基础科学的最新进展表明，动脉粥样硬化应被视为一种慢性炎症过程，并且炎症在动脉粥样硬化从起始到进展及并发症的整个过程中都起着关键作用。在过去几年中，许多研究探讨了炎症生化标志物在各种临床环境中作为冠心病（CHD）风险预测指标的可能性。几项大型前瞻性流行病学研究一致表明，无论是有冠心病病史的患者还是看似健康的受试者，血浆C反应蛋白（CRP）和白细胞介素-6（IL-6）水平都是未来心血管事件风险的强有力独立预测指标。这些分子有助于补充传统风险因素，以及识别易患动脉粥样硬化的新人群类别。一个有趣的问题是，这些炎症分子仅仅是全身炎症的敏感标志物，还是它们积极参与动脉粥样硬化病变的形成和不稳定过程。在本文中，我们将综述有关CRP和IL-6的心血管预后价值以及它们在动脉粥样硬化发生中潜在直接作用的证据。
