Daskalopoulou Stella S, Mikhailidis Dimitri P
Curr Med Res Opin. 2006 Oct;22(10):2037-9. doi: 10.1185/030079906X148364.
Recent guidelines recommend strict goals for low density lipoprotein cholesterol (LDL-C) (70-100 mg/dL; 1.8-2.6 mmol/L). These goals were set following the publication of several trials. In the current issue of the journal, a study compares different doses of the combination tablet (ezetimibe/simvastatin) with statin monotherapy (rosuvastatin). In keeping with previous literature, the combination therapy was more effective in achieving LDL-C goals. This editorial comments on the potential disadvantages of using monotherapy with high-dose statins and considers the issue of statin-induced proteinuria. Combination therapy may need to be increasingly used to achieve the LDL-C targets set by recent guidelines.
近期指南推荐了低密度脂蛋白胆固醇(LDL-C)的严格目标(70 - 100毫克/分升;1.8 - 2.6毫摩尔/升)。这些目标是在多项试验发表后设定的。在该期刊的当前期,一项研究比较了不同剂量的复方片剂(依折麦布/辛伐他汀)与他汀类单药治疗(瑞舒伐他汀)。与先前的文献一致,联合治疗在实现LDL-C目标方面更有效。这篇社论评论了使用高剂量他汀类药物单药治疗的潜在弊端,并探讨了他汀类药物引起蛋白尿的问题。可能需要越来越多地使用联合治疗来实现近期指南设定的LDL-C目标。