他汀类药物与血管平滑肌细胞凋亡

血管平滑肌细胞（VSMC）的异常增殖和迁移在粥样斑块形成和冠状动脉介入治疗（PCI）后再狭窄中起非常重要的作用。他汀类药物不仅是一种有效的调脂药，同时还有多种调脂以外的作用。如他汀类药物可以抑制VSMC的增殖和迁移，并诱导其凋亡。临近病变部位的中层VSMC的凋亡可能造成斑块纤维帽容易破裂，进而引起斑块不稳定和临床事件。但研究证实他汀类药物有稳定斑块的作用，且新生内膜VSMC对他汀类药物诱导的凋亡作用比普通的血管中层VSMC更敏感。因此，他汀类药物的促新生内膜VSMC凋亡作用可能对预防PCI术后再狭窄起有益作用。具体作用机制以及临床上如何合理发挥此类作用尚待进一步研究。

Statins and vascular smooth muscle cell apoptosis

Abnormal proliferation and migration of vascular smooth muscle cells (VSMCs) play a crucial role in athermatous plaque formation and restenosis after percutaneous coronary intervention (PCI).Statins are effective in reducing serum cholesterol levels as well as other lipid-unrelated changes, e.g.,inhibition of the proliferation and migration of VSMCs to induce apoptosis.Apoptosis of VMSCs in media adjacent to atherosclerotic lesions may contribute to fibrous cap weakening,thereby leading to plaque unstabilization and clinical adverse events.Some studies suggested that statins stabilize the plaques and are more active against neointima VSMCs than media VSMCs.Thus,statin-induced apopto- sis of the neointima VSMCs may have beneficial effects on prevention of restenosis after PCI.Further studies on the possible mechanisms and rationale for clinical application are essential.