Stolarz-Skrzypek Katarzyna, Bednarski Adam, Drozdz Dorota, Czarnecka Danuta
I Klinika Kardiologii i Nadciśnienia Tetniczego, Instytut Kardiologii, Uniwersytet Jagielloński Collegium Medicum, Kraków.
Przegl Lek. 2013;70(2):57-64.
Cardiovascular diseases remain the leading cause of death in Poland and in Europe. Children rarely suffer from them, although most of the risk factors which accelerate progression of atherosclerosis commence in childhood, including: dyslipidemias, hypertension, diabetes, and obesity. Moreover during last few years the incidence of some of risk factors in children, such as obesity, diabetes and dyslipidemia has increased significantly. It is known from the autopsy studies that atherosclerosis can be identified at very young age in healthy children. In adult population medications such as HMG-CoA reductase inhibitors (statins) and acetylsalicylic acid (ASA, aspirin) have strong position confirmed by many multicenter clinical trials. They significantly reduce cardiovascular risk and increase life expectancy. Latest recommendations on management of hyperlipidemias in children expand indications for screening of lipid level imbalances and indicate statins as main pharmacotherapy after failure of life style changes. On the other hand acetylsalicylic acid is not used so broadly. Only children at high risk of thrombosis may benefit from its antiplatelet property. This review presents the latest recommendations and the therapeutic role of these medications in pediatric population.
心血管疾病仍然是波兰和欧洲的主要死因。儿童很少患心血管疾病，尽管大多数加速动脉粥样硬化进展的危险因素始于儿童期，包括：血脂异常、高血压、糖尿病和肥胖。此外，在过去几年中，儿童中的一些危险因素，如肥胖、糖尿病和血脂异常的发病率显著增加。尸检研究表明，在非常年幼的健康儿童中就可以发现动脉粥样硬化。在成年人群中，诸如HMG-CoA还原酶抑制剂（他汀类药物）和乙酰水杨酸（ASA，阿司匹林）等药物，已被许多多中心临床试验证实具有重要地位。它们能显著降低心血管风险并延长预期寿命。关于儿童高脂血症管理的最新建议扩大了脂质水平失衡筛查的适应症，并指出在生活方式改变失败后，他汀类药物是主要的药物治疗方法。另一方面，乙酰水杨酸的使用并不那么广泛。只有血栓形成高危儿童可能受益于其抗血小板特性。本综述介绍了这些药物在儿科人群中的最新建议和治疗作用。
