Rosenson Robert S
Department of Medicine and Preventive Medicine, Preventive Cardiology Center, Northwestern University, The Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Am J Cardiol. 2002 Nov 20;90(10B):2K-7K. doi: 10.1016/s0002-9149(02)02966-1.
The use of combination lipid-altering therapy for dyslipidemia is becoming increasingly important for effective management of patients with coronary heart disease (CHD). In accordance with the Adult Treatment Panel III guidelines, the primary target of therapy is lowering low-density lipoprotein (LDL) cholesterol. Studies have demonstrated the benefit of LDL cholesterol reduction in decreasing CHD event rates and all-cause mortality. However, low high-density lipoprotein (HDL) cholesterol remains a significant predictor of CHD events. In addition, lipid-lowering therapy targeting aberrant lipoprotein subclass and triglyceride levels afford additional benefit for patients with mixed dyslipidemias. Aggressive lipid-altering therapy often requires the use of combination therapy involving statins in conjunction with niacin, fibric-acid derivatives, or bile acid resins or intestinal inhibitors of active cholesterol transport. This article reviews the rationale for the use of combination therapy in the treatment of dyslipidemia, highlighting management strategies.
联合使用调脂疗法治疗血脂异常对于冠心病（CHD）患者的有效管理正变得越来越重要。根据成人治疗小组第三次指南，治疗的主要目标是降低低密度脂蛋白（LDL）胆固醇。研究表明降低LDL胆固醇在降低CHD事件发生率和全因死亡率方面具有益处。然而，低高密度脂蛋白（HDL）胆固醇仍然是CHD事件的一个重要预测指标。此外，针对异常脂蛋白亚类和甘油三酯水平的降脂治疗为混合性血脂异常患者带来额外益处。积极的调脂治疗通常需要联合使用他汀类药物与烟酸、纤维酸衍生物、胆汁酸树脂或活性胆固醇转运的肠道抑制剂。本文综述了联合治疗用于血脂异常治疗的基本原理，并重点介绍了管理策略。
