动脉粥样硬化的本质是免疫反应发生的炎症过程,氧化的低密度脂蛋白等抗原在动脉内膜下触发了固有免疫(非特异性免疫)和适应性免疫(特异性免疫)反应。斑块中的免疫炎性细胞包括巨噬细胞、CD4+和CD8+T细胞、B细胞、树突状细胞(DCs)、调节性T细胞(Treg)、NK细胞、嗜中性粒细胞和肥大细胞等。目前发现他汀类药物有明确的抗炎和免疫抑制作用,临床上已用于部分自身免疫性疾病的辅助治疗。他汀在动脉粥样硬化中的疗效源于其降脂和抗炎的双重作用。超敏C反应蛋白(hsCRP)是动脉粥样硬化的炎性生物学标志之一,升高的hsCRP与低密度脂蛋白都是心脑血管事件发生的危险因素,在预测血管事件发生上可能具有同等重要的作用。在动脉粥样硬化的防治中,要对低密度脂蛋白和超敏C反应蛋白进行双重控制。
It has been demonstrated that the pathogenesis of atherosclerosis is characteristic of inflammation and immune responses, which includes innate and adaptive immune responses to oxidative lipoprotein. The immune cells in the ath- erosclerotic plaque include macrophages, CD4 + and CD8 + T cells, B cells, dendritic cells, regulatory T cells, NK cells, neurophils and mast cells. Statins have anti-inflammatory and immune suppressive roles and have been applied in the treatment of autoimmune diseases. The statin benefit observed in the atherosclerosis is due to both lipid-lowing and anti-inflammatory effects. Hypersensitive C-reactive protein ( hsCRP), an inflammatory marker of atherosclerosis, and low-density lipoprotein cholesterol ( LDL-C ) are equally strong predictors of cardiovascular risk. Both LDL-C and hsCRP should be monitored in the prevention and treatment of atherosclerosis.