Stahn Annett, Hanefeld Markolf
Zentrum für klinische Studien, Fiedlerstraße 34, Dresden, Germany.
Clin Res Cardiol Suppl. 2011 May;6:10-6. doi: 10.1007/s11789-011-0031-5.
In the multifactorial process of atherogenesis not only increased LDL-cholesterol but also decreased HDL-cholesterol and raised triglycerides correlate closely to cardiovascular events. Multiple studies have demonstrated a high prevalence of dyslipidemia and the metabolic syndrome in Germany.Statins remain first-line therapy for the treatment of dyslipidemia. However, despite therapy a relevant cardiovascular risk remains. Therefore, it is important to also aim for an adequate treatment of hypertriglyceridemia and also to raise HDL-levels. Many combination therapies have been shown to be effective in treating dyslipidemia. Adding Omega-3-fatty acids, nicotinic acid/laropiprant or a fibrate to statin monotherapy provide additional beneficial lipid-modifying effects for combined dyslipidemia. In the future a recommendation for the treatment of mixed hyperlipoproteinemia with decreased HDL, raised triglycerides and LDL-cholesterol shall have to be added to our guidelines.
在动脉粥样硬化形成的多因素过程中，不仅低密度脂蛋白胆固醇升高，而且高密度脂蛋白胆固醇降低和甘油三酯升高都与心血管事件密切相关。多项研究表明德国血脂异常和代谢综合征的患病率很高。他汀类药物仍然是治疗血脂异常的一线疗法。然而，尽管进行了治疗，仍存在相关的心血管风险。因此，对高甘油三酯血症进行充分治疗并提高高密度脂蛋白水平也很重要。许多联合疗法已被证明对治疗血脂异常有效。在他汀类药物单药治疗中添加ω-3脂肪酸、烟酸/拉罗匹仑或贝特类药物可为混合性血脂异常提供额外有益的脂质调节作用。未来，我们的指南中将必须增加针对高密度脂蛋白降低、甘油三酯和低密度脂蛋白胆固醇升高的混合性高脂蛋白血症治疗的建议。
