Freiberger Tomáš, Vaclová Martina, Tichý Lukáš, Soška Vladimír, Bláha Vladimír, Fajkusová Lenka, Češka Richard, Vrablík Michal
Vnitr Lek. 2016 Fall;62(11):924-928.
Familial hypercholesterolemia (FH) is the most frequent autosomal dominant hereditary disease which is characterized by a decreased LDL-cholesterol catabolism and early clinical manifestation of atherosclerosis affecting blood vessels. The MedPed (Make early diagnosis to Prevent early deaths) project aims to diagnose patients with FH as early as possible, so that they can profit the most from a therapy started in a timely manner and avoid premature cardiovascular events. Currently, as of 31 October 2016, the Czech national database keeps records of 6 947 patients with FH from 5 223 families. Considering the prevalence of FH equalling 1 : 250, this represents 17.4 % of the overall expected number of patients with FH in the Czech Republic. Determining the mutation responsible for FH, now using a next generation sequencing technology in the Czech Republic, brings with it higher diagnostic accuracy, better cooperation of patients and in particular facilitation of cascade screening in families. Although we are among the most successful countries in the world with regard to FH detection, the majority of patients are still undiagnosed. Moreover, as it turns out, most FH patients do not reach the target values with the current therapeutic possibilities. In this regard the newly approved hypolipidemic drugs, PCSK9 inhibitors, to be hopefully available also in the Czech Republic in the near future for chosen patients with FH at high risk, hold great promise.Key words: cascade screening - familial hypercholesterolemia - LDL-cholesterol - MedPed.
家族性高胆固醇血症(FH)是最常见的常染色体显性遗传病,其特征是低密度脂蛋白胆固醇分解代谢降低以及影响血管的动脉粥样硬化早期临床表现。MedPed(早期诊断以预防早期死亡)项目旨在尽早诊断FH患者,以便他们能从及时开始的治疗中获得最大益处,并避免过早发生心血管事件。目前,截至2016年10月31日,捷克国家数据库记录了来自5223个家庭的6947例FH患者。考虑到FH的患病率为1:250,这占捷克共和国FH患者预期总数的17.4%。目前在捷克共和国使用下一代测序技术确定导致FH的突变,带来了更高的诊断准确性、患者更好的合作,特别是便于在家庭中进行级联筛查。尽管在FH检测方面我们是世界上最成功的国家之一,但大多数患者仍未被诊断出来。此外,事实证明,大多数FH患者目前的治疗方法无法达到目标值。在这方面,新批准的降血脂药物PCSK9抑制剂有望在不久的将来也在捷克共和国为选定的高危FH患者提供,前景广阔。关键词:级联筛查 - 家族性高胆固醇血症 - 低密度脂蛋白胆固醇 - MedPed