ºïùîïàðè÷ µïàòï÷, 2ï 2008

Transcription

1 ｧ9 6ｾ4TOMA 2008; 36 : B ｧ fiapple H apple ｧ ｧ8 0ｷ30ｹ0 apple ｹ0 00apple ｸ707fi ｹ0 020ｷ ｷ ﾒ ﾌ0803 ﾌ0809 ﾇ6ｾ4 1, ｦﾐ. 08 ﾌ0806 ﾌ6ｾ4 2 6ﾑ ｧ apple ｧ80ｹ0 ﾌ ｧ80ｹ0, ｧ9 0ｹ ｧ9 0ｹ0 6ﾑ800080ｸ702000ｸ ｷ307, ﾌ ｧ8 6ｾ ｧ8 ﾞ Periodontal inflammation as a risk factor for ischemic cardiovascular diseases V. KOUNOUPIS 1, I. VOUROS 2 Depart. of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki ｧ ﾒ ｧ apple ｦ apple ｧ ｸ ｹ0 07 apple020ｸ70900 閨07000ｹ ｹ0, ｧ 閨 ｹ0 020ｷ fi030ｷ ｸ ｷ ｹ0 07 apple020ｸ70404fi ｹ ｹ0. 6ﾒ ｸ702 6ｧ9 0403fi apple030804apple ｹ fi ｦ ｹ0 0000apple ｧ80ｹ ｸ ｸ70ｹ0 apple apple 閨 ｹ ｧ8030ｸ ｹ ｸ707 鐶pple ｹ ｧ9 0ｹ0 07fi04080ｸ7. ﾇ ｧ8030ｸ apple ｧ9 006ｧ9 apple ｸ ｧ8 apple ｧ ｧ9 apple080ｸ , 020ｸ7036ｧ90ｷ30ｹ0, ｹ0 000ｸ70ｸ802 閨0ｹ ｧ9000ｹ0 00 閨04080ｸ 閨03080ｸ70ｹ0. 6ｾ46ｦ000080ｷ ｸ7applefi apple ｧ804000ｷ30ｹ , ｸ 閨0ｹ ｹ ｦ007 0ｷ30ｹ ｸ fi07000ｹ ｹ ｸ ｦ ｧ9080ｸ7 applefi fi07080ｸ70ｹ0 apple ｹ ｸ ｧ9ｨB080ｸ707 0ｷ30ｹ0 0208apple06026ｧ ｹ ｧ9. 6ｾ402060ｹ0 07fi04080ｸ70ｹ ｸ7 apple ｧ9080ｸ7 08 apple fi0ｹ0 036ｦ ｹ0 apple ｧ ｧ8 apple08030ｸ ｷ307 apple fi- 070ｷ Gram ｧ90ｷ307, 020ｷ307 08apple086ｧ90ｷ ｧ904 0ｸ ｸ7apple ｧ ｸ7apple0800apple fi 040ｸ fi fi apple080ｸ ｧ9ｨB0006 apple03086ｦ ｧ90ｷ apple ｧ9 07 apple 閨 fi0706 0ｸ7apple ｧ ｧ9. ﾇ ｧ9 0ｸ7026ｧ8 apple ｧ9 040ｸ ｧ apple ｧ8 apple ｸ703 閨030ｷ ｸ ｧ9 020ｷ ｷ apple080ｸ ｦ ｸ 閨07 00apple6ｧ9apple fi ｹ0 apple ｧ80ｹ ｧ80ｹ apple apple fi ｸ ｦ ｸ703096ｧ ｧ ｧ9 020ｷ ｸ ﾇ apple ｧ apple006ｧ9 00apple0608 閨 ｧ90ｷ ｷ307 00apple06apple 陦0ｷ ｧ ｷ ｷ apple 03 09fi07020ｷ307 apple080ｸ 閨 ｧ ｹ ｧ8030ｸ ｹ ｸ702fi 00apple ｧ ｸ7apple0ｷ303006ｧ9 09 0ｸ7applefi fi apple006ｧ ｹ0 apple ｧ80ｹ ｧ80ｹ0 040ｸ ｧ90ｷ ｸ ｦ007080ｸ ｹ fi 07fi apple apple apple080ｸ7 apple 03 閨04080ｸ ｧ ｹ0, ｸ707 00apple ｹ 閨0409 apple ｧ ｹ ｷ 閨07080ｸ7 07 0ｸ7apple ｸ ｷ300 閨07000ｹ0 apple08 006ｧ ｹ ｹ0 040ｸ70404 閨 ｹ ｹ0 apple ｧ80ｹ0 07fi04080ｸ ｷ ｷ307 apple ｦ apple fi ｹ fi ｹ0 00apple 閨0ｹ0 閨03000ｸ707000ｹ0. E6ｦ1EI6ｾ4 K EI04IA: ﾞ ｧ8030ｸ , 006ｧ ｹ0 apple ｧ80ｹ ｧ80ｹ0, ｧ800 02, apple ｧ Summary It is generally accepted that cigarette smoking, hypertension and hypercholesterolemia have been established as some of the most considerable risk factors for cardiovascular diseases. In developed countries, cardiovascular diseases account for 50% of deaths and are the principle cause of death, while in developing countries it ranks third, accounting for 16% of deaths. In recent years, efforts have been made in order to explore the contribution of inflammatory factor to the pathogenesis of atherosclerosis, and consequently to the coronary heart disease. Atherosclerosis has been defined as a progressive disease process that involves the medium sized muscular arteries. According to the response to injury hypothesis, atherosclerotic lesions initiate as injury on the vascular endothelium from pathogenic microorganisms and then continue as local inflammatory process. The initiation of atherosclerotic plaques is thought to be the local accumulation of lipids and other plasma proteins in the arterial intima. The deposition of atherogenic lipoproteins LDL, 6 5-VLDL and Lp(a) in the intima may induce a series of biological changes, including increased adhesion molecules in endothelial cells, and the adhesion and migration of monocytes and T lymphocytes. The accumulation of lipidloaded cells underlying the endothelium, namely fatty streak, is a hallmark of early-stage atherosclerotic lesion. As fatty steaks progress to intermediate and advanced lesions they tend to form a fibrous cap consisting of a mixture of smooth muscle cells and extracellular matrix that covers the advanced lesion. The rupture of the fibrous cap can rapidly lead to thrombosis and usually occurs at sites of thinning of the fibrous cap. Periodontal pocket contains abundant Gram-negative bacteria which come into contact with subepithelial underlying connective tissue and periodontal blood vessels. KEY WORDS: Atherosclerosis, cardiovascular diseases, periodontal inflammatory markers, periodontitis. 6ｾ ｹ ﾑ ｧ ｹ ﾌ ｧ ｹ0 2 6ﾑ8apple6ｧ902080ｸ703080ｹ0 ﾒ ｧ80ｹ0 Received on 3 rd May Accepted on 5 th Sept., Dentist 2 Assistant Professor

2 13112 This may lead to subclinical chronic bacteremia, as a result of which inflammatory markers are periodically and constantly released into the bloodstream. The increased circulating levels of these markers can be found in the active phase of periodontal inflammation and they probably favour the formation and progression of atherosclerotic plaques. Proinflammatory cytokines including IL-1, IL-6 and TNF-a upregulate expression of adhesion molecules and leukocyte-endothelium interactions. IL-6 stimulates release of neutrophil leukocytes and platelets into circulating blood. Also, IL-6 and other cytokines alter hepatic protein synthesis, increasing synthesis and release of C-reactive protein, serum amyloid A, fibrinogen and other hemostatic variables which play a key role in the atherosclerotic process. Especially, CRP is now viewed as a prominent partaker in endothelial dysfunction and atherosclerosis. A strong relationship was demonstrated between increased serum CRP and the presence of subgingival periodontal microorganisms. Multiple periodontal pathogens have been found in the atheromas, including P. gingivalis, P. intermedia, T. forsythensis and A.a. Periodontal therapy induces a reduction in serum inflammatory markers which are associated with atherosclerotic process. Taking this into account, it can be hypothesized that periodontal therapy may reduce the risk for cardiovascular disease. There are many studies which provide indications, but they cannot prove sufficiently the correlation between periodontitis and cardiovascular diseases. More case control and long-term longitudinal studies are needed to confirm the association between periodontal and cardiovascular diseases. 6ﾑ ｷ3096ｧ8 ﾒ ｧ ｧ apple , 09 0ｸ7apple 閨 ｸ7apple ｧ ｷ303086ｦ applefi 02080ｸ70ｹ fi ｸ70ｹ0 apple ｹ ｦ007080ｸ ｷ ｷ307. 6ﾑ8apple6ｧ904090ｹ0, 09070ｷ ｧ ｷ300 閨 apple ｹ0 00apple ｸ707fi ｹ0 006ｧ ｹ ｧ802090ｹ0, 09 閨 ｷ ｧ80ｹ ｹ ｸ7apple fi ｹ0. 6ﾑ8apple6ｧ ｧ ｸ7 09. ﾌ ｸ707 fi ｧ ｧ ｸ7apple006ｦ0030ｸ % 020ｷ ｷ307 apple ｧ90ｷ30ｹ0, apple ｹ ｦ apple080ｸ70ｹ0. 6ｾ apple020ｸ ｹ ｹ0, ｧ ｸ7036ｦ % 020ｷ ｷ apple ｦ apple ｧ9, apple020ｸ70404fi ｹ ｹ ｧ 閨 ｹ fi030ｷ ｸ ｷ H ｧ8 07fi04080ｹ0 006ｧ apple ｧ ｸ ｹ0 ﾇ.09. ﾞ ｸ ｹ ｦ fi ｦ , ｧ ｧ ｦ apple080ｸ70ｹ0. 6ﾑ80707 fi000ｷ30ｹ ｦ ｧ ｧ , 040ｸ 閨07, ｧ90ｹ ｧ9 0ｹ , 閨 apple ｦ , ｹ0 apple ｧ apple07070ｷ3 applefi fi- 03 apple apple080ｸ70ｹ02. ﾇ ｧ apple apple ｧ fi 07fi040900, ｧ9ｨB ｷ30ｹ ｷ300 閨 ｷ ｸ7 000ｸ ｧ9080ｸ apple0802 閨 ｷ300 閨 apple 03026ｧ fi ｷ ｸ709fi ﾒ080ｸ707086ｦ0apple090ｹ0, 08086ｦ003080ｹ0 040ｸ ｸ ｸ 閨07 00apple6ｧ9apple fi030ｷ ﾇ ｧ8030ｸ apple ｧ apple ｧ ｧ ｸ ｦ0 040ｸ704026ｧ ｹ0, 09 08apple086ｧ9 apple ｧ ｧ8 (0402 閨070ｷ30409) 6ｧ ｧ8 applefi ｸ ｦ0 0ｸ703086ｦ apple 02fi03080ｸ apple03fi ｦ0 applefi07080ｸ7 6ｧ 閨080ｹ ｹ ｸ7 000ｸ ｧ9080ｸ7. ﾇ ｧ8 applefi ｷ ｧ90ｷ apple ｧ9 040ｸ700apple 閨 ｹ0 fi02080ｸ 閨070ｷ ｧ 閨 (apple07070ｷ3 applefi 02 2/ ｸ7 0ｸ703086ｦ0), ｸ ｸ7apple fi fiapple0ｷ304090ｹ0 ( ). ﾇ apple036ｧ803090ｹ0 applefi apple ｧ ｦ0 閨 ｸ7 000ｸ ｧ9080ｸ7, 閨 apple 閨 ｸ7 6ｧ ｹ apple ｧ ｸ7 000ｸ ｧ9080ｸ7. 6ﾒ ｸ702 6ｧ9 0403fi0706 閨 ｸ 閨0ｹ0 apple030804apple ｹ fi ｦ ｹ0 apple ｧ80ｹ0 0000apple ｧ80ｹ ｷ307 apple 03 09fi07020ｷ307 00apple ｸ707fi ｹ apple 閨 ｹ ｧ9 0ｹ0 07fi04080ｸ7, 0000 閨 ｸ7036ｧ90ｷ30ｹ ｧ 閨07, 0ｸ7apple ｸ ｧ ｹ0 040ｸ ｦ ｦ ｹ0 apple ｧ80ｹ0 07fi04080ｸ ｹ ｸ703096ｧ9 0ｹ ｸ ｧ9. ﾇ apple ｧ8 07fi04080ｹ0 006ｧ ｧ9 0403fi ｧ apple086ｧ9 0000apple ｸ7036ｧ ｸ 閨07 00apple6ｧ9apple ｧ9 apple ｹ0 apple080ｸ7 apple fi ｸ ｦ ｸ703096ｧ apple ｧ907080ｸ ｧ ｧ9 020ｷ ｸ ｧ , applefi07, fi ｦ008 apple 036ｧ ｹ ｧ9ｨB080ｸ apple ｹ fi ｹ 閨 fi0206 閨04080ｸ707 apple08030ｸ7apple ｧ apple 閨070006, ｧ8 apple , apple ｹ0, ｨB apple ｸ70ｹ0 apple ｹ ｦ007080ｸ7, fiapple0ｷ30ｹ apple , ｹ ｧ802090ｹ0, ｧ stress. 08apple ｸ ｧ ｹ0 fi apple ｹ0 020ｸ ｧ907000ｹ0 IL-I, IL-6, TNF apple030ｷ302000ｹ107000ｹ ｹ ｧ9 0ｹ ｹ ｹ ｧ80ｹ0 (C apple030ｷ302000ｹ ｷ3 0809fi0708) apple ｦ007 apple ｹ0 apple080ｸ7 00apple ｨB080ｸ apple ｧ ｧ ｹ ｸ ｧ80ｹ ｹ0. ﾌ06 080ｸ7046ｧ9000ｹ0 0ｸ702 閨0ｹ0 apple ｦ007 apple ｧ ｧ 閨0ｹ ｹ0 apple ｧ80ｹ ｧ80ｹ0. 6ｾ40208applefi0ｹ ｹ ｧ80ｹ0 0ｸ7026ｧ80ｹ fiapple ｹ0 006ｧ 閨 ｸ ｷ307 apple 03 apple07070ｷ3 apple 03 09fi07020ｷ apple086ｧ ｦ ｸ 閨07 00apple6ｧ9apple fi ｹ0 apple ｧ80ｹ ｧ80ｹ0, apple ｸ 閨04080ｸ ｹ0 apple 閨0ｹ ｧ9000ｹ ｹ ｸ ｧ80ｹ ｹ apple0802 閨 ｸ ｦ ｸ707080ｸ802 閨0ｹ0 040ｸ707036ｧ802000ｹ fi 02090ｹ ｧ ｧ ｸ703096ｧ9 0ｹ ｹ ｸ ｧ80ｹ ｹ0 ﾇ ｧ8030ｸ apple ｧ9 006ｧ9 apple ｸ fi apple ｧ apple08030ｸ7apple ｧ ｧ ｦ ｸ70407fi ｹ ｹ0 000ｸ70ｸ802 閨0ｹ ｧ9000ｹ ｧ9080ｸ 閨03080ｸ70ｹ0. 6ｾ ｹ 閨0ｹ0 03 閨 ｹ ｸ ｦ0 閨 ｸ7, fiapple0ｷ30ｹ ｹ ｧ9 020ｷ ｧ90ｷ ｧ ｸ7 6ｧ ｹ0 006ｧ ｹ , ｸ707 鐶pple0006, ｸ ｦ ｦ000 -

3 13H apple ｧ ｧ8 0ｷ30ｹ0 apple ｹ0 00apple ｸ707fi ｹ0 020ｷ ｷ apple ｧ ｹ03. 6ｾ46ｦ000080ｷ ｸ7applefi ｹ0 apple 07026ｧ804000ｷ30ｹ ｹ ｧ8030ｸ ｹ0 (response-to injury hypothesis of atherosclerosis) 4ｨC6, ｧ8 020ｷ ｸ ｷ ｷ ｹ ｧ80ｹ ｸ7 6ｧ ｹ apple ｹ0 03 閨 ｹ ｸ ｦ ｹ0, apple ｧ9 閨07 07 applefi 02080ｸ70ｹ0 apple08030ｸ ｸ70ｹ0 apple ｹ ｦ007080ｸ7, apple086ｧ ｧ ｸ7070ｸ 閨 ｧ8030ｸ ,7ｨC9. ﾇ ｸ ｧ9080ｸ7 006ｧ fi 046ｦ ｸ7applefi ｸ7026ｧ8 apple ｹ0 0ｸ ｸ703096ｧ9000ｹ fi030ｷ ﾌ06 0ｸ ｸ703096ｧ9000ｹ ｸ ｧ9080ｸ7 apple080ｸ7 apple ｦ ｧ ) ｧ ｹ0 06 apple fi ｹ ｸ ｧ9080ｸ7 0ｷ30ｹ ｦ0, 2) 閨0ｹ0 020ｷ ｷ ｧ8020ｷ ｹ ｧ80ｹ0 00apple ｹ0, 3) 09 apple ｷ3096ｧ ｷ apple 03 09fi07020ｷ ｸ ｧ9080ｸ ) 09 0ｸ 閨0709 apple ｸ703 閨030ｷ ｸ704apple ｧ ｧ90ｷ307. 6ｾ fi 03fi apple03fi ｹ ｧ8030ｸ ｹ0 apple 6ｧ9ｨB080ｸ apple08apple 閨07000ｹ 閨0ｹ0 0306apple08apple030ｷ302000ｸ fi apple ｹ0 apple080ｸ7 閨04080ｸ707 apple ｧ ｸ ｧ ｹ ｹ0 0ｸ702 閨0ｹ011. 6ﾒ ｦ ｸ fi 閨 apple ｦ00ｹ fi apple ｧ80ｹ0 020ｷ ｷ ｷ ｷ fi030ｷ ｧ90ｷ307, fiapple0ｷ30ｹ0 09 Chlamydia pneumoniae ｸ fi0ｹ0 (CMV). 6ﾑ8apple06apple03 閨0807, ｧ ｸ fi0ｹ ｹ ｧ9 0ｹ0 07fi04080ｸ Helicobacter pylori, 09070ｷ30402fi fi apple ｸ7 apple00apple ｦ0 閨 ｸ70ｹ012. 6ｾ402060ｹ0 07fi04080ｸ70ｹ ｸ7 apple ｧ9080ｸ7 08 apple fi0ｹ0 036ｦ ｹ0 apple ｧ ｧ8 apple08030ｸ ｷ307 apple fi070ｷ Gram ｧ90ｷ307. ﾇ apple ｧ ｧ904 0ｸ ｸ ｸ7apple ｧ ｸ7apple0800apple fi 040ｸ fi fi apple080ｸ ｧ9ｨB0006 apple03086ｦ ｧ90ｷ30409 apple ｧ 閨0ｹ 閨0ｹ0 0403fi0706 0ｸ7apple ｧ ｧ9. ﾇ ｧ9 0ｸ7026ｧ8 apple ｧ9 040ｸ ｧ apple ｧ8 apple ｸ703 閨030ｷ ｸ ｧ ｹ0 C ｹ0 apple030ｷ302000ｹ107090ｹ0, 02090ｹ ｸ70208apple030ｷ302000ｹ107090ｹ0 apple ｧ907090ｹ0, 02090ｹ0 1-1a ｸ76 76ｧ907090ｹ0, 02080ｸ ｷ3 0809fi07080ｸ7, 020ｷ fi030ｷ ｸ ｹ ｧ80ｹ0 apple080ｸ7 006ｧ 閨0ｹ apple 閨 ｷ307 07fi040ｷ ｸ7 apple ｧ9080ｸ7. ﾌ06 apple ｹ0 0ｸ702086ｧ apple ｦ apple fi ｸ70902fi ｷ apple ｧ90ｷ307, apple ｸ ｧ8 040ｸ ｸ apple06 6ｧ90ｷ 閨040ｷ ｷ fi 020ｷ ｸ ｷ307, 02 08apple086ｧ9 006ｧ fi090ｷ ｹ0 040ｸ ｸ704090ｹ0 0306apple06 6ｧ90ｷ ｸ fiapple ｸ70ｹ0 ( 閨 apple06 6ｧ90ｷ307). ﾌ ｧ9000ｹ0 0ｸ702 閨0ｹ0, apple ｧ80ｹ0 apple ｧ8 020ｷ307 08apple086ｧ90ｷ ｧ 閨040ｷ30ｹ0 apple ｷ3, 000ｸ ｦ ｧ ｸ703096ｧ9 0ｹ ｹ ｸ ｧ80ｹ ｹ ｹ0 0303fi006 50ｷ304090ｹ0 020ｷ ｧ90ｷ ﾑ8apple06apple03 閨0807, fi ｹ ｹ0 apple ｧ907080ｸ fi 020ｷ apple06 6ｧ90ｷ apple ｹ ｸ70ｹ ｦ00ｹ ｦ00ｹ ｸ ｧ , apple030806fi0702 fiapple0ｷ30ｹ apple08apple08030ｸ ｧ902000ｹ0 020ｷ ｧ90ｷ307, 006ｧ ｸ707 02fi ｧ903080ｸ ｦ apple03080ｹ0 閨 fi030ｷ ｸ ｹ ｧ80ｹ0 (ｦﾐL-1, IL ﾒ2NF-a). ﾌ 閨0ｹ0 0ｸ702 閨0ｹ0 080ｸ7046ｧ9000ｹ0 apple080ｸ7 apple applefi ｦ0080ｸ 閨 apple ｷ3096ｧ ｷ fi07080ｸ ｧ9ｨB080ｸ ｸ7 0007ｨB6ｦ000080ｸ ｹ0 0306apple08apple030ｷ302000ｸ ｧ80ｹ0 0306apple ｹ apple0802 閨 apple03fi apple ｧ9 0ｹ014,15. 6ﾒ2 0306apple6ｧ ｸ ｦ007 0ｷ30ｹ0 apple0ｸ7036ｧ807 0ｹ ｦ0 006ｧ9 0ｹ ｸ70ｹ0 apple ｹ0, 09 08apple086ｧ9 apple 閨 ｷ300 閨 ｧ apple ｧ9, fiapple0ｷ30ｹ ｦ ｸ707 閨040006, fi 02090ｹ0 apple ｷ 閨07090ｹ ｧ8030ｸ ｹ0. ﾌ 閨0ｹ0 apple080ｸ7 apple ｦ ｹ ｸ703096ｧ9 0ｹ0 020ｷ ｸ ｸ fi ｧ ｾ402060ｹ0 apple ｹ0 0ｸ702 閨0ｹ 閨0ｹ0 apple080ｸ7 0ｸ7086ｧ ｧ apple ｸ apple fi ｸ apple08apple030ｷ302000ｹ107000ｹ ｸ ｸ7 apple ｹ0. ﾇ ｧ8 040ｸ70902 閨 ｷ apple06 6ｧ90ｷ307 ( 閨03000ｹ fi03090ｹ0 applefi 0306apple08apple030ｷ302000ｹ107000ｹ ｧ80ｹ0 apple0ｸ70207fi ｹ0, LDL) ｷ307 apple030ｷ302000ｸ ｸ7 apple ｹ 閨040ｷ ｷ ｸ ｸ fi fi 02090ｹ ｷ ｧ80ｹ0 apple ｹ016. 6ｾ40ｸ 閨07, 09 0ｸ 閨 ｸ70902 閨 ｷ apple ｷ apple08apple030ｷ302000ｸ LDL, 6 5-VLDL Lp(a) 閨070ｷ30ｹ0 07 apple applefi ｸ70ｹ 閨040ｷ ｷ ｧ9 0ｷ ｸ70ｹ Ox-LDL, apple086ｧ9000ｹ0 apple ｦ007 6ｧ9040ｷ30ｹ ｦ ｧ ｹ 閨 ｹ0, ｹ0 040ｸ ｸ fi 020ｷ ｸ ｷ ﾇ 0ｸ 閨 apple fi ｸ ｧ9080ｸ ｹ ｧ90ｹ0 0306apple08apple030ｷ302006ｧ907000ｹ0 LDL, 6 5- VLDL LP( ) 006ｧ ｸ707 02fi 07 00apple0608 閨 閨0ｹ 閨0ｹ0, fiapple0ｷ30ｹ ｧ904040ｸ ｹ0 閨 ｹ0 020ｷ ｧ90ｷ307 apple fi ｹ ｦ , 09 apple fi ｸ ｷ ｸ ｷ ｷ307 6ﾒ ｸ ｷ ﾒ ｷ ｧ90ｷ ｹ ｧ8030ｸ ｹ ｦ apple ｧ apple ｦ007 0ｸ7apple ｦ applefi 閨0ｹ apple ｹ0 020ｸ ｧ907000ｹ ｹ applefi 00fi0306 apple fi ｹ0, fiapple0ｷ30ｹ fi apple fi ｹ ｷ ｸ ｷ307, ｸ fi 00fi apple fi ｹ0-1, 09 6ﾑ ｧ ｧ ｨC apple fi ｷ ｸ ｷ ｷ307 6ﾒ ｸ ｷ ｦ , apple ｧ ｸ ｸ ｸ7apple fi ｹ ｦ00ｹ ｧ80ｹ0 apple030ｷ302006ｧ907090ｹ ｷ ｸ ｷ307 (MCF- 1) 22,23. ﾒ ｷ ｸ702 6ｧ90ｷ ｧ ｦ ｧ 閨0ｹ 閨040ｷ ｷ , apple086ｧ90806 apple ｦ ｧ9 020ｷ ｸ ｷ ｸ7apple ｧ ﾌ fi 閨0ｹ0 006ｧ ｸ ｧ907000ｹ0 IL TNF-a, 09 MCF-1, ｷ300 閨07000ｹ0 0306apple08apple030ｷ302000ｹ107000ｹ ｧ80ｹ0 apple0ｸ70207fi ｹ ｹ0 080ｸ7046ｧ9000ｹ05. ﾒ 03060ｹ 閨 ｹ apple ｦ ｸ7apple fi , 0ｸ apple ｦ ｸ7 apple 閨 ｹ0 apple ｸ ｷ307/ ｷ307 (M-CSF) 24,25. ﾇ ｧ9 0ｸ7026ｧ8 apple ｧ

4 13114 閨 ｷ307 0ｸ7apple 閨0ｷ (scavenger receptors) apple ｷ ｷ ｾ ｸ707 閨040006, 閨04080ｸ7 020ｷ307 0ｸ7apple 閨0ｷ307 0ｸ apple ｸ ｹ apple08apple 閨07000ｹ0 0306apple08apple030ｷ ｹ107000ｹ0 (0306apple6ｧ9 06 apple fi applefi 02060ｹ ｷ300 閨07000ｹ0 0306apple08apple030ｷ302000ｹ107000ｹ ｧ80ｹ0 apple0ｸ70207fi ｹ0) 鐶pple ｦ ﾑ80202fi0ｹ0 020ｷ307 apple 閨07020ｷ307, apple ｧ apple086ｧ ｷ307 6ﾒ ｸ ｷ307 fi02 07 apple 03080ｸ ｨB ｸ70ｹ0 0ｸ7apple ｧ90ｹ ｸ70ｹ0 0ｷ30ｹ fi apple08apple 閨07000ｹ0 0306apple08apple030ｷ302000ｹ107000ｹ027. 6ﾒ apple 閨07 6ﾒ ｦ ｧ907080ｸ ｸ ｧ fi (ｦﾐ03F-09), 09 08apple086ｧ9 apple ｧ ｹ ｧ9000ｹ ｸ ｦ0 020ｷ ｸ ｷ307, 02080ｸ7 apple apple ｦ0 020ｷ ｧ90ｷ ｸ70ｸ ｸ ｷ ｹ0 046ｦ ｹ0 020ｷ apple030ｷ302000ｸ , 00apple ｨB ｹ fi ｹ ｷ ｧ80ｹ0 apple ｹ021. (6ﾑ ) ｹ 閨0ｹ0 apple080ｸ7 0ｸ7086ｧ fi ｧ ｹ0 00apple 02fi03080ｸ703000ｹ ｧ9000ｹ0 (apple fi ｸ ｸ ｷ ｧ , ｸ ｸ7apple fi , apple086ｧ ｸ ｷ apple086ｧ ﾒ ｸ ｷ307), ｸ703006ｧ fi0ｹ0 020ｷ apple0ｷ ｷ307 apple080ｸ7 006ｧ apple030ｷ30600fi ｹ ｧ8030ｸ ｹ025. ﾌ apple ｹ ｹ0 040ｸ7076ｧ , 020ｸ7036ｧ90ｷ30ｹ0, applefi ｦ apple 閨07 6ﾒ ｦ ｾ ｸ707 閨040006, ｸ apple 03 09fi07020ｷ ｹ0 0ｸ ｸ 閨 ｹ0, ｹ0 apple ｧ ｸ ｷ ｧ90ｷ ｸ70ｸ ｸ ｷ307 applefi 閨 閨040ｷ ｷ ｸ ｸ ｷ ｸ ｷ307 0ｸ ｷ3 applefi ｦ ﾒ ｦ ｹ0 0306apple06 080ｸ70ｹ ｷ304090ｹ04. ﾇ ｧ ｹ ｧ80ｹ0 040ｸ707 閨 ｹ ｧ 閨 ｸ ｦ007 6ｧ ｷ ｸ ｷ ｸ fi07080ｸ ｸ7 0ｸ7apple ｦ ｦ0, 0000 apple0802 閨 ｸ , 040ｸ70902fi apple086ｧ ｷ apple ｧ90ｷ307. ﾇ apple086ｧ ｷ apple ｧ90ｷ307 apple ｧ apple ｸ703 閨030ｷ30409 applefi ｧ9 020ｷ307 0ｸ apple 03 09fi07020ｷ307, 000ｸ ｹ fiapple08 0ｸ702fi ｸ703096ｧ9 0303fi ｸ7. ﾌ06 0ｸ ｧ9 apple ﾑ80602fi ｹ 閨0ｹ ｸ ｦ ｧ9080ｸ7 (6ﾒ20308apple08apple 閨 fi07 applefi Ross 1999). ﾒ080ｸ707086ｦ0apple090ｹ0, 08086ｦ003080ｹ0 6ﾑ80602fi ｾ fi0ｹ0 0306apple06 080ｸ70ｹ ｷ304090ｹ0 (6ﾒ20308apple08apple 閨 fi07 applefi Ross 1999) ｹ fi0ｹ0 applefi apple applefi apple , 02 08apple086ｧ ｸ70ｹ0 apple 6ｧ9ｨB080ｸ fi 03fi 閨 閨 ｷ307 apple ｷ 閨070ｷ ｧ ｧ ｹ ｹ apple03fi fi006 50ｷ304090ｹ0 (6ﾑ ). ﾒ 03060ｹ apple ｹ ｹ ｧ apple ｷ 閨07000ｹ0, apple ｧ ｷ ｹ ｧ80ｹ ｸ7 6ｧ ｹ 閨070ｷ ｸ ｧ9080ｸ7, 0008 ｯ fi ｸ702 閨0ｹ0 apple ｸ fi0ｹ ｸ ｦ0 0ｸ703086ｦ0. ﾇ apple ｷ 閨 ｹ ｧ8030ｸ ｹ ｧ ｹ0 apple (fibrous plaque), 09 08apple086ｧ9 apple ｧ applefi apple0ｸ7036ｧ ﾒ ｦ applefi 0306apple6ｧ9 06. ﾌ apple0ｸ7036ｧ807 0ｹ ｹ0 apple ｷ 閨07090ｹ ｹ ｦ0apple applefi (fibrous cap), 09 08apple086ｧ9 040ｸ7076ｧ applefi 03006ｧ9 000ｸ70ｸ ｦ , 0000 apple0ｸ fi07080ｸ apple030ｷ ｸ ﾑ8076ｧ ｷ3 applefi apple0ｸ7036ｧ807 apple ｦ apple0804fi ｹ ｷ300 閨07080ｸ ｦ0 (necrotic core) applefi apple08apple6ｧ9- apple ｦ ｸ7apple ｧ ｸ ｷ fi03090ｹ0. ﾇ fi ｹ ｷ ｧ80ｹ0 apple ｹ fi applefi ｦ ｧ ｹ0. ﾇ ｧ8 apple apple ｧ applefi ｷ300 閨 fi ｧ8 040ｸ70902 閨 ｷ apple06 6ｧ90ｷ307, 08 08apple086ｧ9080ｹ ｦ0apple applefi 0300apple026ｧ ｸ apple03086ｦ ｷ3020ｸ ｸ7046ｧ ｧ9 000ｸ70ｸ ｦ ﾞ 閨020ｷ30ｹ0, ｧ ｷ ｧ8 apple apple ｧ ｸ70902 閨 ｷ apple06 6ｧ90ｷ apple026ｧ ｹ ｧ9 000ｸ70ｸ ｦ ｷ3020ｸ ｸ7046ｧ 閨0ｹ0 apple ｹ0 apple080ｸ7 閨 ｹ applefi ｸ7apple ｧ ｷ fi fi 0ｸ7apple ｦ ｧ ｧ apple6ｧ9apple ｧ9 0ｹ003, 02fi ｧ ｸ707 02fi 07 0ｸ7apple ｧ ｧ ｧ ｧ ｸ70ｸ ｦ ｷ300 閨 ｦ fi07080ｸ7. 6ｾ ｧ9 0ｸ ｧ904 0ｸ ｸ ｷ apple030ｷ ｸ ｧ fi ( ﾒ ｦ ) apple ｧ9 apple08 fi ｷ ｸ ｹ ｷ3020ｸ ｹ0 080ｸ7046ｧ9 0ｹ ｹ ｸ70ｹ ｹ0, ｹ ｧ ｹ 閨0ｹ0 apple06 閨 ｹ0. 6ｾ ｧ ｷ ｧ8 apple ｷ fi0ｹ fi0ｹ0 apple ｧ ｧ8 040ｸ70902 閨 ｷ304090ｹ0 0306apple06 6ｧ90ｷ ｹ0 0ｸ 閨0ｹ0 apple06 閨 ｹ (6ﾑ )

5 13H apple ｧ ｧ8 0ｷ300 apple ｹ0 00apple ｸ707fi ｹ0 020ｷ ｷ ｧ9, 0000 apple0802 閨 ｸ703096ｧ9 0303fi ｸ 閨 ｹ ｸ ｧ9080ｸ74. 6ﾒ2 6ｦ ｷ ｧ ｸ ｹ0 020ｷ ｧ90ｷ 閨 applefi 02080ｸ70ｹ fi03080ｸ70ｹ ｦ00ｹ ｸ70ｹ0 apple080ｸ ｨB ｧ9 020ｷ ｧ90ｷ307 (6ﾑ ) ﾞ ｹ0 02 apple 03 apple07070ｷ ｧ ｧ90ｹ ｸ700apple 閨 fi ｧ9 apple ｹ0 apple080ｸ ｧ9ｨB080ｸ fi fi 03fi0308 (ｦﾐL-1, IL-6, TNF) ｧ ｹ0 apple ｧ80ｹ ｧ80ｹ0, 040ｸ 閨04080ｸ apple 閨0ｹ ｹ ｹ0 apple 閨 ｹ ｹ ｸ ｧ80ｹ ｹ ｸ ｦ ｸ707080ｸ802 閨0ｹ0 apple030800apple0803 閨 ｹ fi0309 apple ｧ ｧ ｹ0. 6ﾑ80602fi ｾ fi0ｹ0 apple ｷ 閨07090ｹ ｹ0 (6ﾒ20308apple08apple 閨 fi07 applefi Ross 1999) ｧ8030ｷ ｷ3036ｧ ｹ ｷ ｧ80ｹ0 apple ｹ ｧ8 020ｷ307 apple ｷ 閨070ｷ ｸ7apple ｧ907 0ｸ707080ｹ0 apple03fi ｹ 閨070ｷ307, 03fi090ｷ3 03 鐶pple020ｸ ｹ ｧ801090ｹ ｹ ｸ70ｹ ｹ0, 09 08apple086ｧ ｧ ｸ703096ｧ9 0303fi ｸ ｸ70ｹ ｧ80ｹ ｦ00ｹ0 : 1) apple ｹ ｸ70ｹ ｹ0 閨 apple 086ｧ ｸ ｸ7 6ｧ ｹ ｧ9 apple030ｷ302000ｹ10709 (tissue factor) apple080ｸ ｧ applefi ｦ apple ｧ ｹ ｹ0, apple ｹ ｸ70ｹ ｦ00ｹ0 apple6ｧ801090ｹ ｸ7 6ｧ ｹ ｸ703096ｧ9 0303fi ｸ717,28. 2) ﾌ06 030ｷ30900 閨0ｹ ｧ ｹ0 020ｷ307 apple ｷ 閨070ｷ ｦ007 0ｷ30ｹ0 03 閨 ｹ0 apple ｧ ｷ30ｹ0 020ｷ apple ｧ90ｷ ｦ ｷ ｦ ｸ apple ｦ0 0303fi ｸ7, 08 08apple086ｧ9080ｹ ｧ ｧ ｧ8 閨 ｸ7 000ｸ ｧ9080ｸ73. 3) 6ﾑ8apple06apple03 閨0807, 09 apple08 fi ｷ ｸ ｹ ｷ3020ｸ ｹ0 080ｸ7046ｧ9 0ｹ ｹ ｸ70ｹ ｹ0 00apple ｧ ｧ ｧ9 applefi 02080ｸ70ｹ fi03080ｸ70ｹ ｦ00ｹ ｸ70ｹ0 (vasa vasorum) apple080ｸ7 apple0308 閨 applefi ﾑ80602fi ｧ ｸ70ｹ ｹ0 (6ﾒ20308apple08apple 閨 fi07 applefi Ross 1999) ｧ ｹ0 apple ｧ80ｹ ｧ80ｹ ｸ fi0ｹ0 0ｸ ｸ ｧ ﾌ06 apple ｹ0 020ｸ ｧ907000ｹ0 apple 6ｧ9ｨB080ｸ fi 03fi ｹ0 020ｸ 閨0ｹ apple ｹ0 apple080ｸ7 apple ｦ ｹ 閨0ｹ ｧ9000ｹ apple ｹ ｧ8030ｸ ｹ0. 00apple0ｷ30ｹ0 apple 閨 , apple ｧ ｹ ｹ ｸ ｧ9080ｸ ｧ applefi , ｦ ｦ apple ｹ0 020ｸ ｧ907000ｹ0 IL-1, IL TNF-a. O06 080ｸ7046ｧ9000ｹ0 0ｸ702 閨0ｹ ｸ7036ｦ007080ｸ ｸ703006ｧ9- ｨB080ｸ ｧ9, apple03 6ｧ ｹ ｧ80ｹ0 apple ｹ 閨0ｹ0 0ｸ702086ｧ ｹ ｧ80ｹ ｧ903080ｸ 閨 ｧ90ｷ307 apple fi ｹ ｧ apple08apple ｦ apple ｧ8 6ｧ ｧ8 046ｦ 閨 ｷ307 apple030ｷ302000ｸ ｸ7 apple ｹ0. 6ﾑ8apple06apple03 閨0807, 0806 apple ｹ0 020ｸ ｧ907000ｹ ｧ903080ｸ 閨 apple ｸ703 閨030ｷ ｸ ｸ ｷ apple ｧ90ｷ apple fi 6ｧ900 applefi ｸ70003fi 020ｷ ﾇ apple ｹ0 020ｸ ｧ90709 IL apple03 6ｧ ｹ ｸ70ｹ0 applefi ｹ fi apple , ｧ 閨 ｷ ｸ fi ｷ ｸ ｸ ｷ ｷ apple ｧ90ｷ307 applefi ｸ70003fi 020ｷ apple fi 6ｧ900. ﾇ 6ｦ ｸ7 040ｸ ｦ ｦ0 020ｷ ｸ ｧ90ｷ ｧ ｸ707 02fi 07 apple apple03fi ｧ8030ｸ ｹ0, 0303fi006 50ｷ304090ｹ ｧ9 0ｹ0 00 閨040ｷ fi030ｷ , fiapple0ｷ30ｹ0 09 apple ｸ ｹ ｧ80ｹ ｧ80ｹ ｧ ｧ9 30,31. ﾞ07026ｧ ｧ ｸ7036ｧ apple ｧ80ｹ 閨02090ｹ apple086ｧ 閨 fi apple6ｧ ｷ ｸ fi ｷ ｸ ｸ ｷ fi ｧ ｸ707026ｧ ｧ apple ｧ ｷ ｧ ｧ902000ｹ0 applefi ｸ fi ﾌ06 apple ｹ0 0ｸ702086ｧ9 fiapple0ｷ30ｹ ｦ ｹ0 036ｧ9ｨB000ｹ ｸ ｸ709fi07080ｸ7, 閨0ｹ0 apple030ｷ ｹ107000ｹ apple ｸ703 閨030ｷ ｷ307 apple030ｷ ｸ ｨB6ｦ0-000ｷ307 (030ｸ70408ｨB6ｦ00009, ) 0007 閨 apple ｦ apple ｦ ﾇ 6ｦ ｸ ｦ0 020ｷ ｸ fi ｷ307 apple ｧ9 apple ｷ fi 006ｧ 閨 ｸ7 000ｸ ｧ9080ｸ733, ｸ7apple ｸ 閨0ｹ0 00apple apple080ｸ ｧ9ｨB080ｸ ｸ70404 閨 ｸ7 040ｸ ｦ ｦ0 020ｷ ｸ ｧ90ｷ

6 ｷ307 apple 03 09fi07020ｷ ｦ007080ｸ7 020ｷ ｷ307 34,35. ﾌ06 Ogawa ｸ 閨03080ｸ707 fi fi0ｹ0 020ｷ ｸ ｧ90ｷ307 00apple ｧ ｧ9ｨB ｦ ｷ307 00apple06apple 陦0ｷ ｷ apple06 6ｧ90ｷ ｧ900, 0404 閨 apple086ｧ9 00apple applefi ｸ70ｹ ｸ 閨0ｹ036. ﾌ 03fi03080ｹ ｹ0 IL-6 006ｧ apple030ｷ fi0ｹ apple08apple086ｧ ｹ0 046ｦ ｹ0 020ｷ307 apple030ｷ302000ｸ ｸ7 apple ｹ0 applefi ｧ8apple 03. 6ｾ40ｸ 閨07, 09 IL ｹ ｹ0 020ｸ ｧ907000ｹ ｦ ｦ ｹ0 046ｦ ｹ 閨 ｹ0 applefi 02 09apple ｦ ｹ0 C ｹ0 apple030ｷ ｹ107090ｹ0, 02080ｸ7 000ｸ ｦ00ｹ0 ﾞ, 02080ｸ ｷ3 0809fi07080ｸ ｷ apple 03 09fi07020ｷ ﾇ fi ｸ7 apple ｹ applefi apple fi ｸ apple030ｷ ｹ107000ｹ ｸ applefi ｷ3 0809fi0708, apple086ｧ908 00apple06-08 閨 ｸ70902fi ｷ ｸ ｸ ｷ307. ﾇ fi ｸ7 apple ｹ ｸ70902fi ｷ ｸ ｧ90ｷ307 apple ｧ9ｨb080ｸ ｸ70402fi ｸ7 6ｧ ｹ037, ｦ ｷ307 00apple06apple 陦0ｷ ｸ ｷ3 0809fi07080ｸ7 apple ｧ90ｷ ｹ ｧ80ｹ ｸ7 6ｧ ｹ0, fi006 50ｷ 閨 ,39. ﾇ 046ｦ ｸ ｷ3 0809fi07080ｸ ｸ ｧ ｷ apple ｧ90ｷ307 apple ｧ ｧ9 apple030800applefi ｹ0 040ｸ70902fi ｹ0 020ｷ apple ｧ90ｷ307 in vivo 40. 6ﾑ8apple06apple03 閨0807, fi ｷ3 0809fi ｷ ｹ ｸ 閨0ｹ ｹ 鐶pple ｹ apple03080ｸ8fi apple ｷ30ｹ ｸ ｸ70ｹ apple086ｧ ｧ903080ｸ ｸ apple apple fi 020ｷ ｧ90ｷ ｸ70ｸ ｸ ｷ307 41,42. 6ﾒ2 000ｸ7036ｧ ｸ ｧ ｹ ｦ0 040ｸ ｧ80ｹ ｸ ｷ3 0809fi ｸ ｸ ｦ ｹ ｷ ｧ80ｹ0 apple ｹ0. 096ｧ apple030ｷ302000ｹ ｹ0 08apple086ｧ9 0ｹ0 09 apple ｷ3096ｧ8 applefi 02 09apple ｦ apple ｧ 閨040ｷ ｹ0 IL-6 006ｧ C apple030ｷ302000ｹ10709 (CRP). ﾇ apple030ｷ302000ｹ ｸ7026ｧ ｧ fi fi0ｹ ｷ3apple6ｧ9ｨB ｧ9000ｷ30109, ｦ000, fi ｸ7apple08016ｧ fi ｸ7036ｧ ｸ707, fi CRP apple applefi ｧ9 000ｸ70ｸ ｦ ｹ ｸ ｧ80ｹ ｹ0, applefi , ｦ ｸ70ｹ ｸ ｹ044,45. 6ﾑ80202fi0ｹ0 applefi ｸ ｧ ｹ0 IL apple ｧ8 046ｦ 閨 ｹ0 CRP, 閨 ｸ ｧ ｹ0 IL ｸ7 TNF (tumor necrosis factor) ｧ9 0ｸ7026ｧ8 46. ﾇ C apple030ｷ302000ｹ10709 apple ｧ applefi apple 閨 ｸ7apple ｹ0 23Kda ｧ apple ｧ90709, 09 08apple086ｧ ｧ9ｨB applefi 006ｧ9 020ｸ ｧ8 apple ｧ ｧ ｧ8 040ｸ ｧ ｧ fi ｧ ｧ8 apple ﾇ apple030ｷ302000ｹ ｸ7026ｧ8 apple ｧ9 閨07 026ｦ0apple ｧ9080ｸ ｹ0, apple080ｸ7 040ｸ707 閨 閨0ｹ 閨0ｹ0 03 閨 ｹ apple086ｧ9000ｹ ｧ ｸ7 020ｸ ｦ ｸ7 6ｧ ｧ apple fi ｧ ﾑ8apple06apple03 閨0807, 006ｧ ｹ0 apple ｷ fi0ｹ0 006ｧ ｹ fi ｧ ｹ0 ｨB0ｷ36ｧ80ｹ apple apple6ｧ9apple ｧ ﾇ apple ｸ ｧ ｹ0 CPR 040ｸ7076ｧ ｸ 閨030ｷ ｷ307 apple fi070ｷ ｧ90ｷ307 apple fi07 00 閨040ｷ ｹ apple086ｧ ｹ ｸ7 040ｸ700apple ﾒ080ｸ707086ｦ0apple090ｹ0, 08086ｦ003080ｹ ｹ ｧ8 08 fi 49. 6ﾒ ｸ700apple036ｧ8030ｷ300 apple ｧ9 046ｦ apple030ｷ302000ｸ ｸ70208apple030ｷ302000ｸ ｸ ｦ ｸ 閨 ｸ fi fi ｷ ｷ307, apple086ｧ ｸ7 08apple086ｧ9080ｸ7 apple ｧ ｧ fi 02090ｹ ｧ80ｹ ｧ80ｹ ｧ ｹ ｸ ｧ8 閨 ｷ ｧ90ｷ307. ﾒ ｸ707 鐶pple ｦ apple08036ｦ ｹ0 apple0804fi ｹ 閨 ｸ7026ｧ80ｹ ｹ0 apple030ｷ302000ｹ107090ｹ0 applefi 02 09apple ｦ 閨070ｷ30ｹ0 07 apple ｧ ｧ ｹ ｧ80ｹ0. ﾌ06 020ｸ ｧ907000ｹ0 (IL-6, IL TNF-a) apple080ｸ ｧ applefi apple ｧ8 020ｷ apple ｦ 閨040ｷ ｹ0 020ｸ ｧ9 0ｹ apple ｷ3-096ｧ ｹ0 CRP applefi ｧ8apple ｷ30ｹ0, 09 0ｸ7apple0003apple ｷ3096ｧ ｹ0 CRP 096ｧ ｹ ｹ ｹ ｸ7006ｧ907090ｹ apple08060ｷ ｷ307 apple030ｷ302000ｸ ｹ ｧ9 0ｹ ｹ ｹ ｧ80ｹ050. 6ｾ apple00036ｧ9apple020ｷ ｷ307 07fi040ｷ ｸ7 apple ｧ9080ｸ ｹ ｧ80ｹ apple ｹ ｹ ｦ ｧ ｧ ｧ fi ｹ0 080ｸ7036ｧ ｹ0. ｮ00000ｷ30ｹ0, 0ｸ 閨07 00apple6ｧ9apple ｹ0 CRP ｦ fi ｹ ｹ0 07fi04080ｸ70ｹ0 fiapple0ｷ30ｹ0 09 apple ｧ90206, fi ｧ ｹ fi ｧ8 applefi C.pneumoniae H. pylori 51. ﾇ CRP apple ｧ ｸ703fi apple ｷ fi 006ｧ ｷ ｷ ﾑ8apple06apple03fi , 006ｧ ｧ ｸ ｧ ｹ ｸ ｸ703096ｧ ｸ ｦ ｧ9080ｸ ｧ8030ｸ ,54. ﾇ apple030ｷ302000ｹ ｸ7026ｧ 閨 apple ｷ ｧ8 016ｧ9 00fi apple ｧ 閨 ｸ ｧ9080ｸ fi , apple6ｧ904090ｹ ｸ 閨 ｧ907-0ｸ ｹ ｦ ｦ0 00apple ｧ9080ｸ apple ｧ80ｹ apple ｹ055ｨC58. 6ﾒ2 00apple6ｧ9apple ｹ0 CRP apple fi ｧ <1mg/L, 1-3mg/L >3mg/L, 0ｸ7apple ｦ0080ｸ ｹ ｧ80ｹ0, 00 閨04090ｹ ｸ ｧ80ｹ0 00apple ｸ707fi ｹ ｧ ｾ40ｸ 閨07, fi fi apple ｷ3-096ｧ80ｹ ｹ0 C ｹ0 apple030ｷ302000ｹ107090ｹ0, 閨 apple ｧ9 fi ｧ ｹ0 apple 閨 ｸ707 閨 apple ｧ ｧ90ｷ ｷ300fi040ｷ ｷ30ｹ0, 閨04080ｸ ｷ303006ｧ ｹ0 apple08030ｸ ｧ ｧ90ｷ307 ( ｸ7046ｧ9 0ｹ0 DNA 0ｷ30ｹ0 apple03080ｹ0 閨 ｸ ｧ9 0608) apple080ｸ7 030ｸ703006ｧ9ｨB080ｸ apple ｷ3096ｧ ｹ0 C ｹ0 apple030ｷ ｹ107090ｹ ｸ707 閨 閨0ｹ apple6ｧ9apple ｹ0 CRP apple ｨC62. 6ﾑ86ｧ apple08036ｦ0 apple fi apple080ｸ7 076ｧ802080ｸ ｸ ｧ80ｹ0 00apple ｸ707fi ｹ ｹ ｷ307, 07 閨04080ｸ707 apple08030ｸ fi apple080ｸ fi ｹ0 apple ｦ00ｹ ｧ80ｹ ｹ0 CRP. H CRP ｧ apple ｸ703 閨030ｷ ｹ0 IL ｹ ｧ907090ｹ0 applefi ｦ , ｦ ｹ 閨 ｸ ｸ ｦ ｧ9080ｸ7 apple fi ｹ0-1, 02080ｸ ｧ9080ｸ7 apple fi ｹ ｷ ｸ ｷ ｹ0 6ﾑ ｧ907090ｹ063, apple ｦ ｸ ｦ ｧ , 09 CRP ｧ apple ｸ703 閨030ｷ ｹ ｧ80ｹ0 apple030ｷ ｧ907090ｹ0-1 applefi ｦ , 09 08apple086ｧ ｹ ｸ ｦ ｸ ｷ ｸ ｸ ｷ307

7 13H apple ｧ ｧ8 0ｷ30ｹ0 apple ｹ0 00apple ｸ707fi ｹ0 020ｷ ｷ ｸ7apple fi ﾑ8apple06apple 閨020ｷ30ｹ0, 閨 applefi CRP 09 apple ｷ3096ｧ ｸ ｦ ｧ9080ｸ7 (03 ﾌ) applefi ｦ ﾌ apple ｹ0 0ｸ702fi0ｹ ｧ9ｨB0006 apple030ｷ fi 03fi ｧ ｸ ｦ0 02fi07080ｸ 閨 apple apple fi 020ｷ ｧ90ｷ ｸ70ｸ ｸ ｷ307, ｧ9 0ｷ ｷ apple08apple030ｷ302000ｸ ｧ80ｹ0 apple0ｸ70207fi ｹ0, apple fi ｸ70902fi ｷ apple ｧ90ｷ307, ｹ apple fi ｷ ｸ ｸ ｷ ｧ ,67. 6ﾑ80202fi0ｹ0 020ｷ307 apple 閨07020ｷ307, 09 CRP ｦ 閨 ｸ7 apple0ｸ ｦ0 apple , 08 08apple086ｧ9080ｹ0 apple ｧ fi ｧ ｹ ｧ8030ｸ ｹ ｹ0 apple ｧ fi ｧ80ｹ 閨 ｹ fi ｧ ﾒ2 閨03080ｹ0, 0ｸ7apple ｸ 閨0ｹ ｹ ｹ ｹ0 CRP ｧ9 000ｸ70ｸ ｦ ｷ ｧ90ｷ307, 09 08apple086ｧ ｦ 閨 fi 020ｷ307 0ｸ7apple 閨0ｷ ｹ ｧ907090ｹ0 026ｦ0apple080ｸ7 1 in vitro in vivo 69. ﾇ ｧ90709 ｦﾐｦﾐ 006ｧ 閨07 0ｹ0 applefi 02080ｸ70ｹ fi ｸ70ｹ ｦ00ｹ0 apple ｹ0 apple080ｸ7 0000apple03 閨 ｸ703096ｧ ｹ ｧ8030ｸ ｹ0. ﾇ apple ｧ9 020ｷ ｸ ｹ ｧ907090ｹ0 II 00apple06020ｸ 閨040ｷ3 020ｷ307 0ｸ7apple 閨0ｷ ｹ ｧ907090ｹ0 I. 6ｾ404 閨0409 apple ｧ80ｹ ｧ80ｹ ｧ80ｹ ｧ80ｹ0 07fi04080ｸ7 ﾌ fi ｹ ｹ0 040ｸ700apple 閨07090ｹ ｹ0 apple ｧ80ｹ0 07fi04080ｸ7 006ｧ ｸ707 02fi 07 apple 閨04080ｸ 閨040ｷ30ｹ ｧ8 applefi apple ｸ703 閨030ｷ ｷ ｹ ｧ80ｹ0, fiapple0ｷ30ｹ apple ｹ0 020ｸ ｧ907000ｹ0 ｦﾐL-1, IL ﾒ2NF-a. 09 閨040ｷ ｸ ｦ ｧ ｹ ｹ0 040ｸ ｧ80ｹ ｧ80ｹ0 apple ｹ0, 0ｸ ｦ 閨 ｷ ｸ ｸ ｹ ｦ ｷ307 00apple06apple 陦0ｷ ｧ ｹ0 C ｹ0 apple030ｷ ｹ107090ｹ applefi 00apple 閨0ｹ 閨02000ｹ0 閨04080ｸ ｧ fi apple ｧ ｹ 閨0ｹ ｹ0 apple080ｸ7 apple ｧ apple 02fi03080ｸ70309 閨02030ｸ ｷ apple 03 09fi07020ｷ ｹ ｧ80ｹ0 006ｧ ｸ707 02fi ｸ ｧ ｹ ｧ80ｹ ｧ80ｹ0 07fi04080ｸ7. 6ｾ ｧ9 040ｸ ｧ 閨0209 apple080ｸ7 apple apple08066ｧ ｹ0 ﾇ.09. ﾞ, 09 apple ｧ8 07fi04080ｹ0 040ｸ707 閨 ｸ 閨07 00apple6ｧ9apple00 apple ｷ ｹ ｹ0 020ｷ ｷ ｾ40ｸ 閨07, 0400 apple ｦ00ｹ ｧ90ｹ0 apple ｧ ｦ ｷ307 00apple06apple 陦0ｷ ｹ0 C ｹ0 apple030ｷ ｹ107090ｹ % ｦ ｸ709066ｧ ﾑ8apple06apple03 閨0807, 09 apple ｧ8 07fi04080ｹ0 040ｸ707 閨 ｧ ｹ ｧ80ｹ0 0ｸ ｸ703096ｧ9 0ｹ ｸ apple ｧ9 0ｹ0 apple080ｸ7 006ｧ ｷ ｧ9 apple ｹ ｦ007080ｸ ｷ307. 6ﾑ8apple0006 6ｧ8, fi000ｷ30ｹ0, apple03fi ｸ ｧ 閨0209, 02 apple 閨 ｸ7026ｧ80ｹ ｧ ｸ ｸ703fi 040ｸ fi, apple ｧ8 040ｸ70404 閨 ｦ ｹ0 apple ｧ80ｹ0 07fi04080ｸ ｷ ｷ307 apple080ｸ ｧ ｸ 閨0ｹ ｹ0. 6ｾ ｸ 閨0ｹ 閨02000ｹ0 (cross-sectional trials) 閨0ｹ0 apple ｸ7036ｧ ｹ0 00 閨 ｹ0 (prospective trials) 02 0ｸ 閨07 00apple6ｧ9apple apple fi 6ｧ fi- 030ｷ ｷ , fiapple0ｷ30ｹ0 09 CRP, ｷ3 0809fi ｸ ｧ907000ｹ0 IL-1, IL TNF-a 040ｸ707 閨 ｦ ｹ ｧ8030ｸ ｹ ｧ907 0ｸ ｹ ｷ307 71ｨC73. ﾇ apple ｧ ｸ ｦ ｷ307 00apple06apple 陦0ｷ ｹ0 CRP, 02090ｹ0 IL ｷ ｸ fi ｷ ｸ ｸ ｷ apple fi 6ｧ900. 6ｾ402080ｸ70ｹ0 apple ｦ00ｹ ｧ90ｹ0 09 apple ｦ ｸ7026ｧ8 6ｦ ｷ ｷ apple 03-09fi07020ｷ 閨 apple ｧ fi ｹ ｸ 閨0ｹ ｹ0, 0ｸ ｹ ｧ907 0ｸ ｹ ｷ ｾ ｧ ｸ ｧ 閨 閨 ｸ70404 閨 ｦ0 00apple06apple 陦0ｷ ｹ ｧ80ｹ fi03090ｹ ｷ apple08apple030ｷ302000ｸ ｧ80ｹ0 apple0ｸ70207fi ｹ ｧ ｸ7 006ｧ apple ｧ80ｹ ｧ9 0ｹ fi ｹ0 (C.P.I.T.N.) 02 06, 040ｸ 閨07, apple 03080ｸ7046ｧ9 apple ｸ ｷ ﾒ2 000ｸ7036ｧ ｹ 閨02090ｹ0 0ｸ7026ｧ80ｹ0 0ｸ7apple ｧ9ｨB080ｸ ｦ ｸ7 00apple06apple ｦ0 020ｷ ｷ ｧ90ｹ apple ｧ8 07fi0408. ﾞ ｧ ｸ7036ｧ 閨02090ｹ apple086ｧ 閨 ｸ 閨07 00apple6ｧ9apple ｹ0 CRP ｧ90ｹ fi 07fi apple 03080ｸ7046ｧ9 apple ｸ ｷ307 > 4mm 76, ｧ90ｹ fi 07fi apple ｧ ｧ ｹ ｧ8 6ｦ ｹ0 CRP ｸ ｷ3 0809fi07080ｸ ｦ ｦ ｾ ｧ90ｹ apple ｧ ｦ ｸ 閨07 00apple6ｧ9apple ｹ0 CRP, 02080ｸ ｷ3 0809fi07080ｸ ｸ7 apple ｸ7 von Willebrand (procoagulant material), 08 08apple086ｧ9080ｹ0 apple apple6ｧ80109, apple fi ｸ70902fi ｷ apple ｧ90ｷ ﾇ apple030ｷ302000ｹ ｸ7026ｧ8 040ｸ707026ｧ , apple ｦ ｧ applefi ｦ , 020ｷ307 08apple086ｧ90ｷ apple0308apple 閨0ｹ0 (procoagulant) 06 06fi ｹ apple ｸ703 閨030ｷ ｸ7 apple von Willebrand 0400 apple000306apple ｹ ｹ ｸ ｧ9080ｸ apple ｹ fi ｹ0 0ｸ702 閨0ｹ ｸ7apple ｸ707 in situ ｸ ｧ ｧ9 4,79. T 00apple6ｧ9apple ｸ7 apple ｸ7 apple von Willebrand fi 02080ｸ7 6ｧ ｹ0 040ｸ ｧ9ｨB apple6ｧ9apple00 020ｷ ｧ90ｷ307 apple fi ｹ0, 0ｸ7apple ｦ ｹ0 apple ｧ8 040ｸ ｦ ｸ7 apple ｸ7 von Willebrand ｷ apple ｷ ｸ ｸ ｷ ｸ ｷ apple ｸ707, 0ｷ30402fi0408, 閨0ｹ0 apple080ｸ ｸ7apple ｧ9ｨB080ｸ 閨 閨 ｦ0 020ｷ ｷ ｹ0 apple ｧ ｹ0. 6ｾ40ｸ 閨07, 0806 Hujoel ｸ 閨03080ｸ fi ｸ7036ｧ 閨 ｦ ｹ0 apple ｧ ｹ ｷ ｷ307, ｧ ｸ7036ｧ apple 03080ｸ ｨB applefi 02080ｸ70ｹ0 Joshipura ｸ apple ｸ 閨0ｹ ｧ ｹ0 fi ｸ ｧ8

8 13118 ﾒ080ｸ707086ｦ0apple090ｹ0, 08086ｦ003080ｹ0 apple ｧ apple006ｧ ｧ9 07fi apple0608 閨 ｧ90ｷ ｷ307 00apple06apple 陦0ｷ ｷ ｷ apple 03 09fi07020ｷ307, fi0ｹ ｸ7 apple ｸ7 von Willebrand ｦ0 020ｷ ｷ apple 03 09fi07020ｷ307, apple ｧ ｧ ｹ ｧ ｧ90ｷ CRP ｹ ｷ300 閨07000ｹ0 0306apple08apple030ｷ302000ｹ107000ｹ ｧ80ｹ0 apple0ｸ70207fi ｹ0 (Ox-LDL) ｹ0 006ｧ807000ｹ ｧ8030ｷ ｹ apple006ｧ9 0ｹ083. 6ｾ46ｦ000080ｷ ｹ 閨02000ｹ Ox-LDL 閨 ｸ fi apple6ｧ9apple apple ｧ9 07fi ｸ70404 閨 ｦ ｹ ｧ9 0ｷ304090ｹ0 020ｷ307 LDL ｹ 閨 ｹ0 apple08 fi apple080ｸ7 apple ｦ Ox-LDL ｸ7apple ｧ ｦ ｸ ｦ ｹ084,85. 6ﾑ8apple6ｧ904090ｹ0 006ｧ9 apple03fi 閨 apple ｧ fi apple06020ｸ 閨0709 apple ｧ apple006ｧ ｷ ｷ307 00apple06apple 陦0ｷ ｹ0 CRP fi 00apple ｧ ｧ ｧ90ｷ ｸ ｦ007080ｸ ｹ0 020ｷ ｷ307 apple080ｸ ｧ9ｨB CRP, ｹ0 0ｸ7applefi apple ｧ8 040ｸ ｧ ｹ0 040ｸ ｧ80ｹ ｸ70ｹ ｧ80ｹ ｧ ｹ ｧ ｹ ｧ8030ｸ ｹ086. 6ｾ ｧ90ｹ fi ｸ700 閨0709 apple ｧ ｧ90ｷ ｷ307 00apple06apple 陦0ｷ ｹ0 C ｹ0 apple030ｷ302000ｹ107090ｹ ｹ0 ｦﾐL-6 040ｸ707 閨 fi 0702 applefi ｹ0 020ｷ307 apple ｨBfi ｸ ｧ apple006ｧ9. ﾌ ｹ0 020ｷ307 00apple06apple 陦0ｷ ｷ ｧ 閨0ｹ ｹ0 apple000306apple ｹ0 apple080ｸ7 06 apple ｧ90ｷ ｷ apple 閨02030ｷ ﾑ8apple6ｧ904090ｹ0, 0ｸ7apple ｸ 閨0ｹ ｸ ｧ ｷ apple 03 09fi07020ｷ apple03 6ｧ ｹ0 040ｸ ｧ80ｹ0 apple ｧ80ｹ apple006ｧ9 0ｹ 閨 apple6ｧ9apple ｹ0 CRP 02080ｸ ｦ , applefi07, apple06026ｧ ｧ8 10mg 02080ｸ ｦ ｸ702036ｧ fi fi0ｹ fi0ｹ ｸ70ｹ0 030ｸ ｸ70ｹ fi0706 apple ｧ90206 apple ｧ90ｷ ｷ307 00apple06apple 陦0ｷ ｹ0 CRP ｸ7 TNF-a. 6ｾ40ｸ 閨07, fi ｹ0 00 閨04000ｹ 閨0ｹ ｹ0 C ｹ0 apple030ｷ ｹ107090ｹ0 apple ｧ ｧ90ｷ30409 applefi 1,6+1,7ng/mL ,93+1,0 ng/ml 88. 6ﾒ2 000ｸ7036ｧ ｹ ｹ 閨02090ｹ 閨03080ｸ 閨 ｦ0 0ｸ 閨070ｷ307 00apple06apple 陦0ｷ ｹ0 CRP fi ｹ0 apple 03080ｸ7046ｧ9 0ｹ0 020ｷ307 apple apple fi070ｷ ｧ90ｷ307 P. gingivalis, T.forsythensis P.intermedia 0ｸ7apple08080ｸ ﾒ2 00apple6ｧ9apple ｹ0 CRP 閨 ｸ 閨 apple 03080ｸ7046ｧ9 apple apple fi070ｷ ｸ7apple08080ｸ ｧ ｷ3-036ｧ9 040ｸ ｧ907 apple080ｸ7 6ｧ ｾ apple030804apple ｧ90ｷ304090ｹ ｹ0 040ｸ70404 閨 ｹ ｹ0 apple ｧ80ｹ0 07fi04080ｸ ｸ 閨07 00apple6ｧ9apple00 020ｷ307 apple030ｷ ｸ ｹ ｧ9 0ｹ ｹ ｹ ｧ80ｹ0, 0207apple ｹ ｸ 閨0ｹ 閨02000ｹ apple086ｧ apple fi 閨 ｦ ｧ9080ｸ apple086ｧ908 apple ｦ apple apple fi gingivalis 90ｨC93. 6ｾ46ｦ000080ｷ apple fi fi 020ｷ ｸ apple ｧ applefi fi 02080ｸ7 P. gingivalis ｧ ｸ703096ｧ ｷ apple ｧ , 閨 ｸ 閨07 00apple6ｧ9apple ｹ0 CRP, 02o0ｸ7 000ｸ ｦ00ｹ0 ﾞ, 02090ｹ0 ｦﾐL-6, 02080ｸ ｧ9080ｸ7 apple fi ｹ ｷ ｸ ｷ ｹ apple030ｷ302000ｸ ｹ0 ｨB ｹ fi. 6ﾑ80202fi0ｹ ｸ7 P. gingivalis 閨 apple 03080ｸ7046ｧ ｷ307 apple apple fi070ｷ ｧ90ｷ307, fiapple0ｷ30ｹ ｹ0 T. forsythensis, 02090ｹ0 P. intermedia ｸ7 ﾞ ｸ7applefi ｷ ｷ apple ,95. 6ﾑ8apple06apple03 閨0807, 0806 S. sanguis P. ginginalis 00apple ｦ apple0608 閨03080ｸ apple086ｧ ｸ70902fi ｷ apple ｧ90ｷ 閨040ｷ3 020ｷ ｦ0040ｷ307 apple030ｷ302000ｸ apple080ｸ 閨02080ｸ ｸ ｧ ｸ70ｹ0 00apple (PAAP, platelet aggregation-associated proteins) 96,97. ﾌ apple08apple08030ｸ ｧ902000ｹ0 020ｷ307 apple apple fi070ｷ ｧ90ｷ fi07 040ｸ ｧ ｸ707 02fi 07 00apple ｸ fi ｸ ｦ ｧ9080ｸ ｹ ｧ8 020ｷ307 apple030ｷ302000ｸ ｷ ｸ ｷ apple0608 閨 ｹ0 apple apple fi 020ｷ ｧ90ｷ ｸ70ｸ ｸ ｷ307. 6ﾑ8apple06apple ｷ30ｹ0, ｧ907000ｹ0 020ｷ ｧ90ｷ 閨 apple ｨB080ｸ apple fi ｸ7 6ｧ ｹ ｦ ｷ307 apple ﾑ80202fi0ｹ0 020ｷ apple080ｸ 閨 閨040ｷ3 020ｷ307 08apple086ｧ90ｷ fi6 506 apple ｦ 閨040ｷ30ｹ ｧ8, 0ｸ7apple ｸ 閨0ｹ0 apple080ｸ7 apple ｸ ｸ70ｹ ｦ00ｹ0 0ｸ7apple006ｦ0030ｸ707080ｸ70ｹ ｸ703096ｧ9 020ｷ ｸ ｾ40ｸ 閨07, apple08apple08030ｸ ｧ902000ｹ0 020ｷ ｧ90ｷ ｸ707 閨 ｧ9 0ｸ ｧ80ｹ0 040ｸ70909 閨 ｹ0 apple030ｷ302000ｹ 陦 02080ｸ7 apple ｹ ｦ000apple apple086ｧ908 apple ｦ0apple apple ｧ ｸ ｧ ｸ70ｹ0 0ｸ7apple ｧ90ｹ0 CD14 020ｷ ｸ ｷ307 6ｧ8 020ｷ ｸ ｷ307. ﾞ0ｸ702fi ｧ ｸ 閨 fi ｷ ｸ ｷ ｸ ｧ9080ｸ ｧ ｸ ｹ0 閨 ｹ0 020ｷ ｧ90ｷ307 apple fi ｹ fi03000ｹ ｹ0 00apple 02fi03080ｸ703000ｹ0 040ｸ707 鐶pple ｹ0. 6ｾ40ｸ700apple ｹ ｹ fi0ｹ 閨04080ｸ ｸ ｧ ｦ ｹ 閨04090ｹ ｹ0 apple ｧ ｹ ｷ ｷ307. ﾞ0ｸ702fi 閨 ｷ30ｹ0 apple ｦ0apple0ｷ fi030ｷ307 0ｸ7apple0803 閨04000ｷ307 00apple07070ｷ 閨00 0ｸ702fi, apple086ｧ9000ｹ0 fi000ｷ30ｹ ｸ707 00apple ｹ ｸ70404 閨 ｹ0 apple ｧ80ｹ ｧ80ｹ ｧ apple ﾇ apple ｧ ｧ ｹ ｧ8030ｸ ｹ0 006ｧ apple08036ｦ0apple ｧ apple086ｧ9 0000apple03 閨 apple08030ｸ ｧ ｧ apple apple ｹ0 apple080ｸ 閨 apple ｧ ｧ ｧ fi apple ｧ apple ｧ9 07 apple 閨 ｧ8 apple ｧ 閨0ｹ ｸ ｦ0 040ｸ704026ｧ ｹ0 00 閨040ｷ ｸ7 0ｸ7apple08080ｸ ｦ 閨07, 08 08apple086ｧ9080ｹ ｸ ｧ9 0ｷ30ｹ ｧ Gram ｧ90ｷ307, apple03080ｸ8fi07020ｷ ｸ ｹ ｧ80ｹ0 apple080ｸ7 apple fi ｸ ｦ ｸ703096ｧ ｹ ｷ ｧ80ｹ0 apple ｹ0. 6ﾑ8apple06apple03 閨0807, ｹ ｧ fi 0003 閨 閨 ｦ0 020ｷ307 02fi000ｷ apple ｧ fi ｹ0 apple 閨0708.

9 13H apple ｧ ｧ8 0ｷ30ｹ0 apple ｹ0 00apple ｸ707fi ｹ0 020ｷ ｷ ﾞ0ｸ7026ｧ apple 閨 ｧ ｦ0 020ｷ307 02fi- 000ｷ apple ｧ ｧ8 00apple ｨB0006 apple ｹ fi ｷ ｷ ｧ907080ｸ707 apple ｹ0 020ｸ ｧ907000ｹ0, apple086ｧ9000ｹ0 046ｦ000080ｷ apple 閨 ｧ9ｨB 閨 ﾑ8apple0800 閨070ｷ30ｹ0, 00apple ｧ9 07 0ｸ7apple0803 閨 ｧ90ｹ0 fi ｸ7036ｧ8 apple apple ｧ ｧ9ｨB080ｸ ｧ ｸ 閨 ｧ907 0ｸ ｸ703096ｧ9 0ｹ ｷ ｯ 00apple 閨 ｧ9 0ｹ0 07fi04080ｸ fi0408, 09 0ｸ7applefi ｸ7026ｧ apple ｹ ｸ 閨07. ﾞ0ｸ702fi apple080ｸ7 00apple ｦ apple086ｦ ｧ fi0206 0ｸ7apple ｧ8, fi ｸ7036ｧ ｧ 閨 ｦ0 apple ｧ ｹ ｷ307 apple080ｸ7 0ｸ7apple ｧ9ｨB applefi 00apple 閨0ｹ 閨02000ｹ fi0408, 0ｸ7apple ｸ apple ｧ fi 020ｷ307 apple fi ｷ apple080ｸ 閨070ｷ30ｹ ｦ (bias) 0402 apple 閨 ｸ70ｹ0. 6ｾ apple 03fi ｷ ｷ apple03 閨 apple ｧ9 apple ｧ9 apple ｹ0 fiapple0ｷ30ｹ0 09 0ｸ7apple ｧ9, 09 apple 040ｸ ｧ9, ｹ ｧ802090ｹ0, 09 0ｸ7apple 閨 , apple , 0208 stress apple086ｧ ｧ apple ｸ707 02fi 閨 ｸ ﾒ fi0ｹ0 0ｸ702fi ｸ707 0ｸ7 0400fi apple 03080ｸ7-046ｧ ｹ0 apple ｧ ｹ0 00apple ｨB ｸ7applefi ｷ300, 閨 ｧ 閨0ｹ apple fi 0000apple03 閨 閨07 0ｹ apple ｧ9 020ｷ ｷ ｸ ｦ0 040ｸ704026ｧ ｹ0. 6ﾑ8apple6ｧ904090ｹ0, 06 apple apple ｧ ｹ fi 080ｸ70ｹ fi ｹ ｹ0 apple ｧ80ｹ0 07fi04080ｸ7 ( fi0ｹ0 0ｸ7apple 0304fi07020ｷ , 006ｧ ｹ0 C.P.I.T.N, ｹ0 030ｸ ｷ307, apple apple03fi04080ｸ ｹ0), ｹ ｦ ｹ0 020ｷ ｸ , 03fi090ｷ ｹ 閨 ｹ fi ｦ0 020ｷ ﾑ8apple06apple03fi , 0ｸ7apple ｸ 閨0ｹ ｦ0 020ｷ fi ｦ ｹ ｧ80ｹ0 apple ｧ9 0ｹ0, 02 03fi 閨0ｹ0 apple 閨0ｹ ｹ0 fiapple0ｷ30ｹ ｦ0 閨 ｸ7 000ｸ ｧ9080ｸ7, fi fi 00apple000604fi 0608, apple ｧ apple , fi0ｹ ｹ ﾇ 04036ｧ80409, applefi07, ｧ90ｷ ｧ9 020ｷ fi030ｷ apple ｧ ｦ009040ｸ apple fi02 02 閨 ｷ30ｹ0 apple0802 閨 ｸ70404 閨 ｹ ｹ0 apple ｧ80ｹ0 07fi04080ｸ ｧ fi apple 03 - apple07070ｷ3 03 apple03 鐶pple ｦ apple06086ｦ ｸ7036ｧ ｷ307 00apple apple080ｸ7 040ｸ707 閨080ｸ ｧ9, 0007 apple 閨070ｷ apple ｧ8 07fi ｧ ｧ8 07fi apple080ｸ7 026ｧ apple ｸ7 08apple086ｧ9-080ｸ7 apple ｹ ｦ ｸ70404 閨 ｦ0 020ｷ307 6ｦ ｷ307, 006ｧ applefi apple006ｧ ｹ0 apple ｧ ｹ fi ｧ8 apple 閨 ｸ7 apple ｧ ｹ0 040ｸ ｧ90ｷ ｸ ｦ007080ｸ ｹ ｦ0 00apple ｧ9080ｸ7. 縺 ｧ ｷ300 閨0709 apple apple 03 apple07070ｷ apple ｧ ｦ ｹ fi0ｹ ｦ fi, 0906 閨 ｷ307 apple 03 09fi07020ｷ ｧ9070ｷ307 apple080ｸ7 0000apple03 閨 apple 閨 ｷ307 6ｦ ｷ307. ﾞ0ｸ702fi 03 00apple ｦ apple ｸ ｧ fi ｷ fi0ｹ ｸ7 0ｸ ｦ0 020ｷ ｸ7apple ｹ , 閨020406, apple ｦ ｸ707 02fi apple6ｧ ｦ0 020ｷ fi030ｷ307 apple apple 03 09fi07020ｷ ｹ ｧ80ｹ0 07fi04080ｸ ｷ ｧ9040ｷ ｹ0 apple ｧ80ｹ ｧ80ｹ ｧ9 1.World Health Organization.The world health report 1995: bridging the gaps. Geneva: WHO, 1995:1. 2.Rosenberg HM, Ventura SJ, Maurer JD, Jenkins D, Kster C. Births and deaths: United States, Monthly vital statistics report; Vol. 45, no3, suppl 2, p.31. Hyattsville, MD: National Center for Health Statistics, Ross R.The pathogenesis of atherogenesis- a perspective for the 1990s. Nature 1993;362 : Ross R. Atherosclerosis- an inflammatory disease. N Eng J Med 1999; 340(2): Ross R. Atherosclerosis is an inflammatory disease. Am Heart J 1999; 138: Ross R, Glomset JA.The pathogenesis of atherosclerosis. N Engl J Med 1976; 295: Ross R, Harker L.Hyperlipidemia and atherosclerosis. Science 1976;193 (4258): Ross R.Atherosclerosis- a problem of the biology of arterial wall cells and their interaction with blood components. Arteriosclerosis 1981;1: Ross R.The pathogenesis of atherosclerosis- an update. N Engl J Med 1986;314 : Glasser SP, Selwyn AF, Ganz P.Atherosclerosis: Risk factors and the vascular endothelium. Am Heart J 1996;131(2): Kuo CC, Gown AM, Bendit EP, Grayston JT.Detection of Chlamydia pneumoniae in aortic lesions of atherosclerosis by immunocytochemical stain. Arterioscler Thromb 1993; 13(10): O ｯ Connor S, Taylor C, Campell LA, Epstein S, Libby P. Pontential infectious etiologies of atherosclerosis: A multifactorial perspective. Emerg Infect Dis 2001; 7(5): Seymour R, Steele J.Is there a link between periodontal disease and coronary heart disease? Br Dent J 1998;184: Gamble JR, Harlan JM, Klebanoff SJ.Stimulation of the adherence of neutrofils to umbilical vein endothelium by human recombinant tumor necrosis factor. Proc Natl Acad Sci USA 1985; 82: Beutler BA, Cerami A.Recombinant interleukin-1 suppresses lipoprotein lipase activity in 3T3-L1 cells. J Immunol 1989; 135: Woolf N. The distribution of fibrin within the aortic intima: an immumohistochemical study. Am J Pathol 1961; 39:

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