冠心病与炎症因子关系研究进展综述

Research Progress Review on the Relationship between Coronary Heart Disease and Inflammatory Factors

摘要: 动脉粥样硬化作为冠心病发病的核心病理基础，慢性低度炎症全程参与血管内皮受损、脂质沉积、泡沫细胞生成、斑块增殖乃至斑块破溃继发血栓等一系列病理变化。伴随分子检验、基因测序及遗传流行病学技术持续进步，越来越多炎症标志物被证实和冠脉狭窄程度、远期心血管不良事件密切关联。本文整合近年临床对照、动物基础试验与孟德尔随机化研究成果，按照急性期标志物、白介素、肿瘤坏死因子与基质蛋白酶、趋化因子、新型氧化应激标志物、非编码RNA调控、脂肪源性炎症七大板块梳理各类炎症分子研究现状，分层阐述促炎、保护性因子的生物学作用与分子通路，客观分析现有研究短板，对临床转化与后续科研方向进行展望，为冠心病抗炎靶向诊疗、病情分层评估提供新思路。

Abstract: Atherosclerosis is the core pathological basis of coronary heart disease (CHD). Chronic low-grade inflammation is involved in the entire pathological process, including vascular endothelial injury, lipid deposition, foam cell formation, plaque proliferation, as well as plaque rupture and secondary thrombosis. With the continuous advancement of molecular detection, gene sequencing and genetic epidemiological technologies, an increasing number of inflammatory markers have been proven to be closely correlated with the severity of coronary artery stenosis and long-term adverse cardiovascular events. This paper summarizes the findings of recent clinical controlled trials, basic animal experiments and Mendelian randomization studies. The research status of various inflammatory molecules is elaborated in seven categories: acute-phase markers, interleukins, tumor necrosis factors and matrix metalloproteinases, chemokines, novel oxidative stress markers, regulation of non-coding RNAs, and adipose-derived inflammation. The biological functions and molecular pathways of pro-inflammatory and protective factors are discussed hierarchically. The deficiencies of existing studies are objectively analyzed, and prospects for clinical transformation and future research directions are put forward, aiming to provide new ideas for targeted anti-inflammatory diagnosis and treatment as well as stratified disease assessment of CHD.