van Leuven Sander I, Kastelein John J P
Department of Vascular Medicine, Academic Medical Center of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Expert Opin Pharmacother. 2005 Jun;6(7):1191-203. doi: 10.1517/14656566.6.7.1191.
The introduction of statins has drastically changed the treatment and prevention of atherosclerotic vascular disease. By lowering lipid levels and reducing the risk of coronary heart disease, these drugs are among the most effective at reducing morbidity and mortality available to clinical practice. In fact, these compounds have demonstrated the reversible nature of the process of atherosclerosis and can be considered the most useful drugs we currently have in our armamentarium in the prevention of atherosclerosis and its clinical sequelae. Atorvastatin provides pronounced lipid lowering in a broad range of individuals with hypercholesterolaemia and, as such, is an appropriate first-line therapy for patients at low to high risk of coronary heart disease. Reductions in total and low-density lipoprotein cholesterol achieved with atorvastatin have been shown to translate into reductions in risk of cardiovascular morbidity and mortality in both primary and secondary prevention settings. Significant clinical benefits have specifically been observed among patients with Type 2 diabetes and in those with acute coronary syndromes. In common with other members of the statin class, atorvastatin is well tolerated, and adverse events are generally mild and transient in nature. Despite the significant clinical benefits provided by atorvastatin, its full potential in the management of atherosclerotic disease has yet to be wholly explored; however, studies currently ongoing will answer many of the outstanding questions.
他汀类药物的引入极大地改变了动脉粥样硬化性血管疾病的治疗和预防。通过降低血脂水平和降低冠心病风险，这些药物是临床实践中降低发病率和死亡率最有效的药物之一。事实上，这些化合物已证明动脉粥样硬化过程具有可逆性，可被视为我们目前预防动脉粥样硬化及其临床后果的药物库中最有用的药物。阿托伐他汀能使广泛的高胆固醇血症患者显著降低血脂，因此，对于冠心病低到高风险的患者来说，它是一种合适的一线治疗药物。在一级和二级预防中，阿托伐他汀降低总胆固醇和低密度脂蛋白胆固醇已被证明可转化为心血管疾病发病率和死亡率风险的降低。在2型糖尿病患者和急性冠状动脉综合征患者中尤其观察到了显著的临床益处。与他汀类药物的其他成员一样，阿托伐他汀耐受性良好，不良事件一般性质轻微且短暂。尽管阿托伐他汀提供了显著的临床益处，但其在动脉粥样硬化疾病管理中的全部潜力尚未得到充分探索；然而，目前正在进行的研究将回答许多悬而未决的问题。
