McCrindle Brian W
Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.
Thromb Res. 2006;118(1):49-58. doi: 10.1016/j.thromres.2005.01.006. Epub 2005 Feb 17.
Hyperlipidemia in children has emerged as an increasingly prevalent risk factor in children, concomitant with the worldwide epidemic of obesity. Hyperlipidemia can alter vascular endothelial function and impair some of its pro-fibrinolytic and anti-thrombotic regulatory properties, as well as initiate the atherosclerotic process. There are strong links between vascular changes and hyperlipidemia in children, both from pathologic and non-invasive assessment studies. More severe lipid abnormalities in children are related to primary familial dyslipidemias. Current recommendations for screening begin with assessment of family history for cardiovascular disease or events or parental hyperlipidemia. High-risk individuals merit more intensive investigation and intervention. While fat-restricted diets have been shown to be safe in children, lipid-lowering is modest. Those with more severe lipid abnormalities may meet criteria for drug therapy, and the statin agents commonly used in adults are increasingly being used in high-risk children, with similar efficacy and safety, although long-term concerns remain.
儿童高脂血症已成为儿童中日益普遍的危险因素，这与全球肥胖症流行相伴。高脂血症可改变血管内皮功能，损害其一些促纤溶和抗血栓调节特性，并引发动脉粥样硬化进程。从病理和非侵入性评估研究来看，儿童血管变化与高脂血症之间存在紧密联系。儿童中更严重的脂质异常与原发性家族性血脂异常有关。目前的筛查建议首先评估心血管疾病或事件的家族史或父母高脂血症情况。高危个体值得进行更深入的调查和干预。虽然限制脂肪饮食已被证明对儿童是安全的，但降脂效果有限。那些脂质异常更严重的儿童可能符合药物治疗标准，成人常用的他汀类药物越来越多地用于高危儿童，疗效和安全性相似，尽管长期影响仍需关注。
