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1、InflammationandCRPPrimaryPro-InflammatoryCytokines(eg,IL-1,TNF-a)IL-6“Messenger”CytokineICAM-1Selectins,HSPs,etc.LiverEndotheliumandothercellsCRPSAAAdaptedfromLibbyPetal.Circulation.1999;100:1148–1150.InflammatoryPathwaysinAtherogenesisCirculationPro-inflammatoryRiskFactorsVSM
2、C migrationFoam-cell formationAdherenceand aggregationof plateletsAdherenceand entryofleukocytesT-cell activationAtherosclerosis: AnInflammatoryDisorderVSMC,vascularsmoothmusclecellmigration.Inflammation,PlaqueStability,andtheRiskofCardiovascularEventsEvidencesuggeststhatinACS
3、elevatedinflammatorymarkers—inparticular,CRP—predictthefutureriskofcardiovasculareventsFactorssuchaslaminararterialshearstress,oxidized LDL,freeradicals,andinfectiousorganismscantriggerthereleaseofpro-inflammatorycytokines(eg,IL-1,TNF-,IL-6)Inflammatorycytokinesinfluencethest
4、abilityand degradationofthefibrouscap,leadingtoplaqueruptureandsubsequentthrombosisACS,acutecoronarysyndrome;CRP,C-reactiveprotein;LDL,low-densitylipoprotein;IL,interleukin;TNF,tumornecrosisfactor.LibbyP,etal.Circulation.2002;105:1135-1143.hs-CRPandRiskofFutureMIinApparentlyHe
5、althyMenP<.001P<.001P=.03Quartileofhs-CRPPTrend<.001RelativeRiskofMI01231234hs-CRP,high-sensitivityC-reactiveprotein;MI,myocardialinfarction.AdaptedfromRidkerPM,etal.NEnglJMed.1997;336:973-979.RelativeRiskofCardiovascularEventsAccordingtoSeveralBiochemicalMarkers01.02.04.06.0L
6、ipoprotein(a)LDLCHomocysteineTCApolipoproteinBTC:HDLChs-CRPhs-CRP+TC:HDLCRelativeRiskofFutureCVEventsCV,cardiovascular;TC,totalcholesterol;LDLC,low-densitylipoproteincholesterol;HDL-C, high-densitylipo-proteincholesterol;CRP,C-reativeprotein;hs-CRP,high-sensitivityC-reactivepr
7、otein;TC,totalcholesterol.AdaptedfromRifaiN,etal.ClinChem.2001;47:28-30.NovelRiskFactorsasPredictorsofPADVCAM,vascularcelladhesionmolecule;LDLC,low-densitylipoproteincholesterol;ICAM,intercellularadhesionmolecule;hs-CRP,high-sensitivityC-reactivemolecule;TC,totalcholesterol;HD
8、L-C,high-densitylipoproteincholesterol.*Adjustedforage,smokin
