發炎如何影響動脈粥狀硬化？發炎指標與抗發炎治療研究

動脈粥狀硬化是一種逐漸進展的病變，會導致多種重要的心血管疾病，例如冠狀動脈疾病、中風與周邊動脈疾病。

Atherosclerosis is known to be a progressive pathology that causes several clinically important cardiovascular diseases (CVDs) such as coronary artery disease, stroke, and peripheral arterial disease.

發炎是串連傳統與新興心血管危險因子、並促成動脈粥狀硬化的共同機制，可能進一步造成冠狀動脈疾病、大動脈血栓性中風與腦動脈瘤。

Inflammation is a common mechanism linking traditional and emerging CV risk factors to the development of atherosclerosis, leading to CAD, large artery thrombotic stroke, and cerebral aneurysms.

從致動脈硬化的脂蛋白滯留在動脈壁，到斑塊形成與破裂，動脈粥狀硬化的每個階段，都有先天與後天免疫交織而成的複雜網絡參與其中。

A complicated network involving both innate and adaptive immunity is involved in every stage of atherosclerosis, from the retention of atherogenic lipoproteins within the arterial wall to the creation and rupture of plaques.

基於慢性發炎參與動脈粥狀硬化形成的概念，許多研究發現，高敏感度 C 反應蛋白（hs-CRP）、IL-6 與 IL-1 等發炎指標，可以用來預測未來發生心血管事件的風險。

Based on the concept that chronic inflammation contributes to the pathogenesis of atherosclerosis, numerous studies have reported that various biomarkers of inflammation such as high sensitive C-reactive protein, IL-6 and IL-1 could predict future cardiovascular events.

statin 降低心血管風險的效果，也印證了發炎在動脈粥狀硬化中的角色。多項研究顯示，statin 的益處大多來自降低血管發炎，而且在某種程度上與它降血脂的作用無關。

The role of inflammation in atherosclerosis is confirmed by the effects of statins in reducing the CV risk. Several studies have shown that most beneficial effects of statins are due to the reduction in vascular inflammation, to some extent independent of their lipid-lowering action.

研究中，canakinumab 顯著降低了非致死性心肌梗塞、非致死性中風或心血管死亡的發生；hs-CRP 濃度也隨之下降，血脂數值則沒有改變。

Canakinumab significantly reduced the occurrence of a non-fatal myocardial infarction (MI), a non-fatal stroke, or a CV death. The concentrations of hsCRP were also reduced, while the lipid levels did not change.

低劑量秋水仙素顯著降低了心肌梗塞與非心因性栓塞缺血性中風的風險，發炎指標也同時下降。

Low-dose colchicine significantly reduced the risk of MI and a non-cardioembolic ischemic stroke, as well as the inflammatory markers.

現有證據支持：發炎在動脈粥狀硬化的各個階段都扮演核心角色。抗發炎治療可以降低血栓風險、且不增加出血併發症，但它對身體防禦機制的影響需要審慎考量，治療時必須了解感染風險與病原體。生活型態調整與社會層面的介入仍是基礎，而新的藥物方向，可能為動脈粥狀硬化患者帶來更多治療選擇。

Current evidence supports a central role for inflammation in all phases of the atherosclerotic process. Anti-inflammatory therapy can reduce thrombotic risk without bleeding complications, but its impact on host defense mechanisms needs careful consideration. Understanding infection risk and pathogens is crucial for treatment. Lifestyle measures and societal interventions are essential, but novel pharmacologic approaches could expand management options for atherosclerotic patients.