残余炎症风险在脑动脉粥样硬化性疾病中的研究进展

doi:10.3969/j.issn.1673-5765.2025.12.015

中国卒中杂志 ›› 2025, Vol. 20 ›› Issue (12): 1583-1589.DOI: 10.3969/j.issn.1673-5765.2025.12.015

残余炎症风险在脑动脉粥样硬化性疾病中的研究进展

石欣欣^1，2*，余莹^1，2*，何鑫^1，2，娄亚柯³，马宁^1，2（*第一作者）

1 北京 100070 首都医科大学附属北京天坛医院介入神经病学科
2 国家神经系统疾病临床医学研究中心
3 首都医科大学附属北京安贞医院心脏瓣膜病介入中心

收稿日期:2025-02-27 修回日期:2025-10-29 接受日期:2025-11-05 出版日期:2025-12-20 发布日期:2025-12-20
通讯作者: 马宁 maning_03@hotmail.com
基金资助:
国家自然科学基金（82171894）

Advances of Residual Inflammatory Risk in Cerebral Artery Atherosclerotic Disease

SHI Xinxin^1,2*, YU Ying^1,2*, HE Xin^1,2, LOU Yake³, MA Ning^1,2 (*contributed equally)

1 Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
2 China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
3 Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China

Received:2025-02-27 Revised:2025-10-29 Accepted:2025-11-05 Online:2025-12-20 Published:2025-12-20
Contact: MA Ning, E-mail: maning_03@hotmail.com

摘要/Abstract

摘要： 脑动脉粥样硬化性疾病（cerebral artery atherosclerotic disease，CAAD）是缺血性卒中的重要致病基础。近年来，残余炎症风险（residual inflammatory risk，RIR）被认为是动脉粥样硬化进展及血管事件复发的重要因素。现有证据显示，RIR与颅内及颈动脉斑块易损性显著相关，并可独立预测卒中复发与不良功能结局，尤其在大动脉粥样硬化亚型患者中关联更强。抗炎药物虽在冠心病中证实有效，但在脑血管病中的临床获益仍存争议——秋水仙碱的试验结果存在差异，而靶向IL-1β或IL-6通路的药物（如卡那单抗、泽韦奇单抗）仍处于探索阶段。综合现有研究进展，RIR正逐步从单纯的炎症指标转变为潜在的干预靶点，有望用于高危CAAD患者的风险分层，并为精准抗炎及降脂联合抗炎双目标治疗策略提供新的研究方向。

文章导读： 本综述系统总结了残余炎症风险在脑动脉粥样硬化性疾病中的研究进展，阐明了其与斑块易损性、卒中复发及功能结局的密切关联，分析了靶向残余炎症风险的抗炎治疗及降脂联合抗炎双目标治疗策略的潜在价值，为探索脑动脉粥样硬化性疾病的精准分层管理与个体化抗炎干预提供了参考。

关键词: 脑动脉粥样硬化; 卒中; 残余炎症风险; 超敏C反应蛋白; 抗炎治疗

Abstract: Cerebral artery atherosclerotic disease (CAAD) is a major pathological basis of ischemic stroke. Recent studies have identified residual inflammatory risk (RIR) as a key driver of atherosclerotic progression and recurrent vascular events. Current evidence indicates that RIR is strongly associated with vulnerable plaques in both intracranial and carotid arteries and independently predicts stroke recurrence and poor functional outcomes, with a stronger correlation particularly in patients with large-artery atherosclerosis. Although anti-inflammatory therapy has shown clear benefits in coronary heart disease, its efficacy in cerebrovascular disease remains controversial. Trials of colchicine have yielded inconsistent results, while agents targeting the IL-1β or IL-6 pathways (such as Canakinumab and Ziltivekimab) are still under investigation. Overall, RIR is evolving from a simple inflammatory marker to a potential therapeutic target. It shows promise for stratifying high-risk CAAD patients and for informing precision anti-inflammatory strategies, including combined lipid-lowering and anti-inflammatory (dual-target) approaches.

Key words: Cerebral atherosclerosis; Stroke; Residual inflammatory risk; High-sensitivity C reactive protein; Anti-inflammatory therapy

中图分类号:

石欣欣, 余莹, 何鑫, 娄亚柯, 马宁. 残余炎症风险在脑动脉粥样硬化性疾病中的研究进展[J]. 中国卒中杂志, 2025, 20(12): 1583-1589.

SHI Xinxin, YU Ying, HE Xin, LOU Yake, MA Ning. Advances of Residual Inflammatory Risk in Cerebral Artery Atherosclerotic Disease[J]. Chinese Journal of Stroke, 2025, 20(12): 1583-1589.

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残余炎症风险在脑动脉粥样硬化性疾病中的研究进展

Advances of Residual Inflammatory Risk in Cerebral Artery Atherosclerotic Disease

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