Grines Cindy L
Division of Cardiology, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
J Interv Cardiol. 2006 Feb;19(1):3-9. doi: 10.1111/j.1540-8183.2006.00097.x.
Recent clinical trials confirm that aggressive lipid-lowering therapy with statins decreases low density lipoprotein (LDL) cholesterol to well below 100 mg/dL in high risk patients, and prevents cardiovascular events. Similarly, aggressive lipid lowering is being explored as a possible means of promoting regression of atherosclerosis and of affording greater protection from atherosclerotic events. A growing body of evidence indicates that intensive statin therapy, particularly in high risk patients, slows the rate of progression of atherosclerosis compared with moderate therapy, and that reductions of > or =40% in LDL cholesterol are necessary to achieve atherosclerosis regression. Questions remain regarding the extent of regression achieved with statin therapy and whether to dose statins to achieve a specific LDL-cholesterol level or a certain percent reduction; however, ongoing clinical trials may provide insight and guidance.
近期临床试验证实，高危患者采用他汀类药物进行积极的降脂治疗可将低密度脂蛋白（LDL）胆固醇水平降至远低于100mg/dL，并预防心血管事件。同样，积极降脂正被探索作为促进动脉粥样硬化消退以及提供更强保护以预防动脉粥样硬化事件的一种可能手段。越来越多的证据表明，与中等强度治疗相比，强化他汀治疗，尤其是在高危患者中，可减缓动脉粥样硬化的进展速度，且LDL胆固醇降低≥40%对于实现动脉粥样硬化消退是必要的。关于他汀治疗所实现的消退程度以及是否根据特定的LDL胆固醇水平或特定的降低百分比来调整他汀剂量仍存在疑问；然而，正在进行中的临床试验可能会提供见解和指导。
