Hegele R A
Departments of Medicine, University of Toronto, Ontario, Canada.
Clin Chim Acta. 1996 Mar 15;246(1-2):21-38. doi: 10.1016/0009-8981(96)06224-9.
Atherogenesis is a complex process. While genetic factors determine the limits under which atherosclerosis develops, environmental factors help to determine a person's risk within these limits. Atherosclerosis proceeds through a series of pathological stages: (a) intimal medial thickening; (b) fatty streaks; (c) intermediate lesions; (d) fibrous plaques; (e) complicated plaques. The key cell types involved in atherosclerosis include endothelial cells, monocytes/macrophages, smooth muscle cells, lymphocytes and platelets. Several hundred gene products have been targeted as potential candidates in the analysis of the genetic component of atherosclerosis. In addition to heredity, the classical risk factors for atherosclerosis include male sex, advancing age, cigarette smoking, high blood pressure, diabetes and abnormal plasma lipids. Ideally, the information derived from newer molecular approaches to define the etiology of atherosclerosis could be integrated into evidence-based practice strategies in order to enhance health care delivery to subjects at high risk.
动脉粥样硬化的形成是一个复杂的过程。虽然遗传因素决定了动脉粥样硬化发生的限度，但环境因素有助于确定在这些限度内一个人的患病风险。动脉粥样硬化通过一系列病理阶段发展：（a）内膜中层增厚；（b）脂纹；（c）中间病变；（d）纤维斑块；（e）复杂斑块。参与动脉粥样硬化的关键细胞类型包括内皮细胞、单核细胞/巨噬细胞、平滑肌细胞、淋巴细胞和血小板。在动脉粥样硬化遗传成分的分析中，已有数百种基因产物被作为潜在候选对象。除了遗传因素外，动脉粥样硬化的经典危险因素还包括男性、年龄增长、吸烟、高血压、糖尿病和血脂异常。理想情况下，从更新的分子方法中获得的用于确定动脉粥样硬化病因的信息可以整合到循证实践策略中，以加强对高危人群的医疗服务。
