Patsch J R
Abteilung für Klinische Atheroskleroseforschung, Universitätsklinik für Innere Medizin, Innsbruck.
Wien Med Wochenschr Suppl. 1989;105:3-7.
Atherosclerosis of coronary and peripheral arteries is a major cause of death and disability in civilizations outside the third world. Disturbances of the lipid transport in plasma are a major cause for atherogenesis. The transport of exogenous and endogenous lipids in plasma is facilitated by lipoproteins. The concentration of the various lipoprotein families is subject to complex regulation such as secretion by intestine and liver, intravascular metabolism and clearance by hepatic and extrahepatic receptors of high and low affinity. To understand the pathophysiology of lipid transport and the role of certain lipoproteins as risk factors for atherosclerosis it is important to understand the regulatory mechanisms governing lipoprotein concentrations. Elevated concentrations of certain lipoproteins such as low-density-lipoproteins (LDL) constitute an increased risk for atherosclerosis. This elevation of LDL in plasma can be caused by increased production and/or reduced catabolism. With a better understanding of the pathophysiology of the lipid transport system more rational and precise modalities of both treatment and prevention of atherosclerosis can be expected.
冠状动脉和外周动脉粥样硬化是第三世界以外地区死亡和残疾的主要原因。血浆中脂质转运紊乱是动脉粥样硬化形成的主要原因。脂蛋白促进血浆中外源性和内源性脂质的转运。各种脂蛋白家族的浓度受到复杂的调节，如肠道和肝脏的分泌、血管内代谢以及肝脏和肝外高亲和力和低亲和力受体的清除。为了理解脂质转运的病理生理学以及某些脂蛋白作为动脉粥样硬化危险因素的作用，了解调节脂蛋白浓度的机制很重要。某些脂蛋白如低密度脂蛋白（LDL）浓度升高会增加动脉粥样硬化的风险。血浆中LDL的这种升高可能是由于产生增加和/或分解代谢减少所致。随着对脂质转运系统病理生理学的更好理解，有望实现更合理、精确的动脉粥样硬化治疗和预防方法。
