每日一题_2023.04.24

A 59-year-old woman with history of morbid obesity, hypercholesterolemia, and diabetes mellitus presents to the emergency department with complaints of substernal chest pain lasting two hours. An ECG reveals ST elevations in the lateral leads. The troponin level at admission is extremely elevated, and a creatine kinase-myocardial bound test is pend- ing. Which of the following is a key cell me- diator in the pathogenesis of an atherosclerotic plaque?

一名59岁女性，有病态肥胖、高胆固醇血症和糖尿病病史，胸骨下胸痛2小时就诊于急诊科。心电图显示侧导联ST段升高。入院时肌钙蛋白水平异常升高，肌酸激酶-心肌结合试验尚待进行。下列哪一项是动脉粥样硬化斑块发病机制中的关键细胞因子?

(A) γ-Interferon

(B) Complement补体

(C) Interleukin-6

(D) Natural killer cells自然杀伤细胞

(E) Platelet-derived growth factor血小板衍生生长因子

答案解析：

血管内损伤后，内皮下空间积聚脂蛋白。接下来，发生脂蛋白的化学修饰(如糖基化或氧化)，将单核细胞招募到血管壁。单核细胞进入内皮下空间后转化为巨噬细胞，发生不受调节的低密度脂蛋白胆固醇大细胞增生，产生泡沫细胞。此时，各种细胞介质，尤其是血小板源性生长因子、肿瘤坏死因子和白细胞介素-1，将血小板和平滑肌招募到内膜，细胞外基质的增殖和产生导致纤维斑块的形成。

正确答案：E