Inflammation, atherosclerosis, and stroke
Inflammation, atherosclerosis, and stroke
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DOI：
10.1097/01.nrl.0000215789.70804.b0
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发表时间：
2006-05-01
期刊：
影响因子：
1.2
通讯作者：
Elkind, Mitehell S. V.
中科院分区：
文献类型：
--
作者：
Elkind, Mitehell S. V.
背景：近年来，炎症作为动脉粥样硬化、冠状动脉疾病和脑卒中的病因受到越来越多的关注。基础和动物研究表明，炎症机制与动脉粥样硬化的发病和进展，以及与斑块破裂和其他动脉粥样硬化血栓事件相关的临床事件有关。综述：回顾了炎症标志物与卒中风险相关的文献，并提供了一个临床实例。几种炎症生物标志物，特别是高敏感性c反应蛋白（hsCRP），已被确定为未来中风风险的可能预测因子。药物治疗，特别是羟甲基戊二酰辅酶A还原酶抑制剂或他汀类药物，已被证明可以降低炎症标志物的水平，而不依赖于对胆固醇的影响。最近，这些药物降低急性冠状动脉疾病患者心肌梗死和其他冠状动脉事件风险的能力已被证明与它们降低hsCRP水平的能力相关。降低hsCRP是否会对中风患者有类似的益处尚不确定，其他药物是否可以类似地降低hsCRP水平也不确定。结论：炎症生物标志物，尤其是hsCRP，可能有助于在初级和二级卒中预防中更好地预测卒中风险。减少炎症的方法正在变得可行，这可能有助于改变这种风险。然而，在炎症标志物成为卒中患者评估的常规部分之前，还需要进一步的研究。
Background: Inflammation has received increasing attention in recent years as a cause of atherosclerosis, coronary artery disease, and stroke. Basic and animal research has implicated inflammatory mechanisms in the pathogenesis and progression of atherosclerosis, as well as in clinical events related to plaque rupture and other atherothrombotic events.Review Summary: The literature on the association of inflammatory markers with risk of stroke was reviewed and a clinical example provided. Several inflammatory biomarkers, and particularly high-sensitivity C-reactive protein (hsCRP), have been identified as likely predictors of the risk of a future stroke. Medications, particularly hydroxymethylglutaryl coenzyme A reductase inhibitors, or statins, have been demonstrated to reduce levels of inflammatory markers independently of effects on cholesterol. Most recently, the ability of these agents to reduce risk of myocardial infarction and other coronary events in patients with acute coronary artery disease has been demonstrated to correlate with their ability to lower levels of hsCRP. Whether reduction of hsCRP would have similar benefits in stroke patients remains unsettled, as does whether other drugs may be similarly used to lower hsCRP levels.Conclusion: Inflammatory biomarkers, especially hsCRP, may allow improved prediction of the risk of stroke in primary and secondary stroke prevention. Modalities to reduce inflammation are becoming available that may help to modify this risk. Further studies, however, are needed before inflammatory markers become a routine part of the evaluation of stroke patients.