Cannon C P
Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
J Intern Med. 2008 Apr;263(4):353-65. doi: 10.1111/j.1365-2796.2008.01933.x.
Whilst statin monotherapy is often sufficient to reach LDL-C goals, treatment may not reach all lipid goals in individuals with mixed dyslipidaemia typically associated with metabolic syndrome or type 2 diabetes. Double or triple combination therapy, which provides the opportunity to address multiple lipid abnormalities simultaneously, may be required to achieve targets in some patients. Addition of fenofibrate or niacin (nicotinic acid) to statin therapy is likely to be the first option, as recommended by national treatment guidelines; omega-3 fatty acids may also be useful. Careful monitoring is required when adding additional agents given the increased potential for drug interactions and side effects.
虽然他汀类药物单药治疗通常足以达到低密度脂蛋白胆固醇(LDL-C)目标,但对于通常与代谢综合征或2型糖尿病相关的混合性血脂异常患者,治疗可能无法实现所有血脂目标。在某些患者中,可能需要双重或三联联合治疗,以便有机会同时解决多种血脂异常问题。按照国家治疗指南的建议,在他汀类药物治疗中添加非诺贝特或烟酸(尼克酸)可能是首选方案;ω-3脂肪酸可能也有用。由于药物相互作用和副作用的可能性增加,在添加其他药物时需要仔细监测。