International Journal of Clinical Research
International Journal of Clinical Research. 2026; 10: (7) ; 10.12208/j.ijcr.20260323 .
总浏览量: 34
云南省第三人民医院/大理大学第二附属医院 云南昆明;
*通讯作者： 王玉波,单位：云南省第三人民医院/大理大学第二附属医院 云南昆明; ；
颈动脉粥样硬化是心脑血管疾病发生发展的重要病理基础，斑块负荷及结构特征与不良心血管事件风险密切相关。在他汀类药物治疗背景下，尽管低密度脂蛋白胆固醇（low-density lipoprotein cholesterol (LDL-C))水平多可达标，多项前瞻性研究及随机对照试验显示患者仍存在残余心血管风险，部分颈动脉斑块可持续存在甚至进展。除血脂异常外，炎症反应、氧化应激及血管壁微环境改变在动脉粥样硬化进展中具有重要作用，构成非LDL-C依赖性残余风险的主要机制。近年来研究表明，脂肪酸代谢，尤其是ω-3和ω-6多不饱和脂肪酸，在调控炎症反应及血管功能方面发挥重要作用，并可能通过影响血管壁局部代谢环境参与斑块演变。本文围绕他汀治疗背景下颈动脉斑块的影像学特征及残余风险进行综述，并探讨脂肪酸代谢作为风险补充评估指标的潜在临床价值。
Carotid atherosclerosis is an important pathological process involved in the development of cardiovascular and cerebrovascular diseases. Plaque burden and plaque composition are both related to the risk for adverse cardiovascular events. Statin therapy can reduce low-density lipoprotein cholesterol (LDL-C) in most patients but there is clinical evidence suggesting that reaching LDL-C targets does not completely eliminate cardiovascular risk. Some patients have stable or progressing carotid plaques even with standard statin treatment. Residual cardiovascular risk has been linked beyond lipid metabolism to inflammation, oxidative stress and alterations within the vascular microenvironment which might drive plaque progression independent of LDL-C. Fatty acid metabolism has been gaining increasing interest due to its role in regulating inflammatory signaling and vascular function with omega-3 and omega-6 polyunsaturated fatty acids potentially influencing plaque progression via modulation of the vascular microenvironment. In this review we discuss carotid plaque characteristics detected using imaging techniques and residual cardiovascular risk while on statin therapy. We also explore how fatty acid metabolism could be used as an additional marker for cardiovascular risk assessment.
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