CAJ | 학술논문

动脉粥样硬化及其相关的心血管疾病的发病率和死亡率至今仍居全球首位。尽管加强了干预措施，但心血管残余风险仍相当高。脂蛋白相关性磷脂酶A2（Lp-PLA2）是一种新型的、独立的血管炎症特异性和动脉粥样硬化特异性生化标记物。大量科学和临床研究证实，Lp-PLA2具有促动脉粥样硬化作用，并与心血管事件的发生呈正相关。目前，根据成年治疗小组Ⅲ（ATP Ⅲ）指南，推荐Lp-PLA2作为传统危险因子的辅助指标，从而可以优化对未来心血管风险的评估。令人鼓舞的是，一种口服的Lp-PLA2特异性抑制剂（Darapladib），其基础研究和临床前期试验取得了显著的成果。同时，有两项正在进行的针对Darapladib的III期临床试验，以评估其改善心血管结局的疗效和安全性。此外，对于中高危的人群，Lp-PLA2对指导危险分层、建立治疗方案和预后评估具有潜在的价值。该文将对Lp-PLA2的生化特性、在动脉粥样硬化中的作用及其在科学和临床研究的结果作出归纳总结。
동맥죽양경화급기상관적심혈관질병적발병솔화사망솔지금잉거전구수위。진관가강료간예조시，단심혈관잔여풍험잉상당고。지단백상관성린지매A2（Lp-PLA2）시일충신형적、독립적혈관염증특이성화동맥죽양경화특이성생화표기물。대량과학화림상연구증실，Lp-PLA2구유촉동맥죽양경화작용，병여심혈관사건적발생정정상관。목전，근거성년치료소조Ⅲ（ATP Ⅲ）지남，추천Lp-PLA2작위전통위험인자적보조지표，종이가이우화대미래심혈관풍험적평고。령인고무적시，일충구복적Lp-PLA2특이성억제제（Darapladib），기기출연구화림상전기시험취득료현저적성과。동시，유량항정재진행적침대Darapladib적III기림상시험，이평고기개선심혈관결국적료효화안전성。차외，대우중고위적인군，Lp-PLA2대지도위험분층、건립치료방안화예후평고구유잠재적개치。해문장대Lp-PLA2적생화특성、재동맥죽양경화중적작용급기재과학화림상연구적결과작출귀납총결。
Atherosclerosis and its associated cardiovascular diseases (CVD)are still the leading cause of morbidity and mortality worldwide. Although intensified interventions have been applied,the residual cardiovascular(CV)risks are still very high. Lipoprotein-associated phospholipase A2 (Lp-PLA2 )is a novel and unique biomarker highly specific for vascular inflammation and atherosclerosis. A large number of basic and clinical studies have demonstrated that Lp-PLA2 is pro-atherogenic and correlates positively with CV events.Currently,in the Adult Treatment Panel III (ATP III)guideline,Lp-PLA2 is recommended as an adjunct to traditional risk factors in assessing the potential CV risks. Encouragingly,darapladib,a specific and orally ac-tive inhibitor of Lp-PLA2 ,has been tested both in basic research and preclinical trials and the outcomes are quite striking. Additionally,there are two phase III clinical trials ongoing to evaluate the efficacy and safety of darapladib on cardiovascular outcomes. With regard to the potential values of Lp-PLA2 in risk stratification, therapeutic regimen establishment and prognosis evaluation in patients with moderate or high risk,this review is to summarize the relevant data about the bio-chemical characteristics of Lp-PLA2 ,the actions of Lp-PLA2 on atherosclerosis and the results of Lp-PLA2 in scientific research and clinical studies.