Levy Deborah R, Pearson Thomas A
University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Clin Cardiol. 2005 Jul;28(7):317-20. doi: 10.1002/clc.4960280703.
Statin monotherapy may not be sufficient to reach serum lipid goals in many patients, especially in those with combined lipid abnormalities. Statins cause only a modest increase in high-density lipoprotein cholesterol (HDL)--an established independent protective factor for coronary heart disease (CHD)--and a modest decrease in triglycerides (TG). Niacin is an effective pharmacologic agent for increasing HDL, as well as lowering TG. Used in combination with a statin, niacin provides an option to help patients attain their low-density lipoprotein cholesterol (LDL-C) goals, non-HDL goals, and HDL goals. Based on the National Health and Nutrition Examination Survey, 1999 to 2000, only 12% of the surveyed adult population were under treatment for diagnosed hypercholesterolemia. Furthermore, only 5.4% of the surveyed population had attained goal total cholesterol levels of < 5.2 mmol/I (< 200 mg/dl). Combination therapy offers a means to get more people to goal. This paper reviews the impact of lipid-modifying combination therapy with niacin plus a statin on lipid profile outcomes.
对于许多患者，尤其是合并血脂异常的患者，他汀类药物单药治疗可能不足以达到血脂目标。他汀类药物仅能适度升高高密度脂蛋白胆固醇（HDL）——一种已确定的冠心病（CHD）独立保护因子，以及适度降低甘油三酯（TG）。烟酸是一种有效升高HDL以及降低TG的药物。与他汀类药物联合使用时，烟酸为帮助患者实现低密度脂蛋白胆固醇（LDL-C）目标、非HDL目标和HDL目标提供了一种选择。根据1999年至2000年的美国国家健康与营养检查调查，在接受调查的成年人群中，只有12%的人因确诊的高胆固醇血症正在接受治疗。此外，在接受调查的人群中，只有5.4%的人达到了总胆固醇水平<5.2 mmol/L（<200 mg/dl）的目标。联合治疗提供了一种让更多人达到目标的方法。本文综述了烟酸加他汀类药物的调脂联合治疗对血脂谱结果的影响。
