冠状动脉粥样硬化性心脏病的自身免疫机制

Autoimmune mechanisms in coronary heart disease

目前研究认为冠心病是一种多因素相关的慢性炎症,而自身免疫在冠心病的发病过程中起重要作用。部分冠心病的传统危险因素与自身免疫有所交叉。自身免疫疾病患者的冠心病早发与好发趋势也提示冠心病与自身免疫相关。对于有明确临床症状的自身免疫疾病患者,自身抗体与冠心病发病各个环节有关。进一步研究无临床症状但自身抗体阳性的人群,发现部分自身抗体与冠心病关系密切。同时细胞免疫也参与冠心病的发生,而其中Th1细胞通过INF-γ轴影响冠心病的发生。冠心病的上述特点符合自身免疫疾病特征,因此,有观点认为,冠心病是自身免疫疾病。这个观点将为临床诊断和治疗冠心病提供新的方向。

There are studies showing that coronary heart disease （CHD） is an immune-related chronic inflammation, and autoimmunity plays an important role in the pathogenesis of CHD. Some traditional CHD risk factors are associated with autoimmunity. Patients with autoimmune diseases usually suffer from CHD praecox, which also suggests that CHD is associated with autoimmune. In patients diagnosed with autoimmune diseases, autoantibodies are associated with CHD in various aspects and procedures. Further studies on asymptomatically autoantibody-positive population found that some autoantibodies are closely related with CHD. Meanwhile, cellular immunity also takes part in CHD. It has been suggested that interferon-γ（INF-γ） produced by Thl cells plays a major role through IFN-γ axis. Therefore, there is a view that CHD is an autoimmune disease. This view will provide a new direction for clinical diagnosis and treatment for CHD.