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急性冠脉综合征主要是由于具有易损性的冠状动脉粥样硬化斑块发生破裂或蚀损,继发血栓形成,并引起具有严重危害的急性冠状动脉事件。炎症反应是影响冠状动脉粥样硬化斑块易损性的主要因素,参与反应的炎症因子是近年来研究的热点。有研究发现白细胞介素-18(IL-18)作为一个促炎症因子,会增加斑块的易损性,而白细胞介素-10(IL-10)作为主要的抗炎症因子,则具有抗动脉硬化及稳定粥样斑块的作用。IL-18/IL-10的比值代表了机体促炎性与抗炎性动态平衡的状态,其比值失衡可能是影响斑块易损性的重要因素。近来有研究认为,IL-18/IL-10的比值可作为急性冠脉综合征患者近期冠脉事件的预测因子。文章就近几年来有关IL-10、IL-18及其比值与冠状动脉粥样硬化斑块易损性的研究进展作一综述,以探讨其可能的临床意义。
Acute coronary syndromes are mainly due to rupture or erosion of a vulnerable atherosclerotic plaque, secondary thrombosis, and acute serious coronary events. Inflammatory reaction is the main factor that affects the vulnerability of atherosclerotic plaque. Inflammatory factors involved in the reaction are the hot spots in recent years. It has been found that interleukin-18 (IL-18), as a proinflammatory factor, increases plaque vulnerability while interleukin-10 (IL-10), as a major anti-inflammatory factor, Hardening and stabilizing the role of atherosclerotic plaque. IL-18 / IL-10 ratio represents the body’s pro-inflammatory and anti-inflammatory homeostasis, the imbalance ratio may be an important factor affecting plaque vulnerability. Recent studies suggest that IL-18 / IL-10 ratio can be used as a predictor of recent coronary events in patients with acute coronary syndrome. In this paper, we reviewed the research progress of IL-10, IL-18 and its ratio and the vulnerability of coronary atherosclerotic plaque in recent years to explore its possible clinical significance.