Davignon J
Am J Cardiol. 1986 Jun 27;57(16):22H-28H. doi: 10.1016/0002-9149(86)90432-7.
Recent experimental and epidemiologic evidence has dispelled all doubts about the need to treat patients with hyperlipidemia. Therapy should focus on 3 areas: control of concomitant risk factors for atherosclerosis, reduction of lipid levels through diet and, if response to diet proves inadequate, administration of lipid-lowering agents. There are 4 categories of first-line drugs: resins, fibrates, nicotinic acid and probucol. Probucol has a sustained effect, additive to that of a lipid-lowering diet; it can reduce total serum cholesterol and cause xanthoma regression even in patients with receptor-defective homozygous familial hypercholesterolemia. It is effective when used alone and has an additive effect when combined with resins or nicotinic acid. Compared with many other lipid-lowering medications, it is well tolerated. Although the combination of probucol and clofibrate may cause a significant decrease in high density lipoproteins, there is no evidence that this decrease carries any adverse consequences for the underlying disease process.
最近的实验和流行病学证据消除了对治疗高脂血症患者必要性的所有疑虑。治疗应集中在三个方面：控制动脉粥样硬化的伴随危险因素，通过饮食降低血脂水平，如果饮食治疗效果不佳，则使用降脂药物。一线药物有四类：树脂类、贝特类、烟酸类和普罗布考。普罗布考具有持续作用，与降脂饮食的作用相加；它可以降低血清总胆固醇，甚至在受体缺陷的纯合子家族性高胆固醇血症患者中也能使黄色瘤消退。单独使用时有效，与树脂类或烟酸类合用时具有相加作用。与许多其他降脂药物相比，它耐受性良好。虽然普罗布考和氯贝丁酯联合使用可能会导致高密度脂蛋白显著降低，但没有证据表明这种降低会对潜在的疾病进程产生任何不良后果。
