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血脂异常治疗的现状与未来——综述

Present and Future of Dyslipidaemia Treatment-A Review.

作者信息

Merćep Iveta, Vujević Andro, Strikić Dominik, Radman Ivana, Pećin Ivan, Reiner Željko

机构信息

Department of Internal Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.

Division of Clinical Pharmacology, Department of Internal Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia.

出版信息

J Clin Med. 2023 Sep 8;12(18):5839. doi: 10.3390/jcm12185839.

Abstract

One of the greatest burdens on the healthcare systems of modern civilization is cardiovascular diseases (CVDs). Therefore, the medical community is looking for ways to reduce the incidence of CVDs. Simple lifestyle changes from an unhealthy to a healthy lifestyle are the cornerstone of prevention, but other risk factors for cardiovascular disease are also being currently targeted, most notably dyslipidaemia. It is well known that lowering serum lipid levels, and in particular lowering elevated LDL-cholesterol, leads to a reduction in major cardiovascular events. Although the focus to date has been on LDL-cholesterol levels and lowering them with statin therapy, this is often not enough because of increased concentrations of other lipoprotein particles in the serum and residual cardiovascular risk. Since lowering LDL-cholesterol levels is successful in most cases, there has been a recent focus on lowering residual cardiovascular risk. In recent years, new therapeutic options have emerged that target triglyceride-rich lipoproteins, lipoprotein (a) and apolipoproteins C and B. The effects of these drugs on serious adverse cardiovascular events are not yet known, but recent studies with some of these drugs have shown significant results in lowering total lipid levels. The aim of this review is to present the current therapeutic options for the treatment of dyslipidaemia and to describe the newly approved drugs as well as the drugs that are still in development. Although at this stage we cannot say with certainty whether these agents will be approved and widely used, it is safe to say that our views on the treatment of dyslipidaemia are certainly changing.

摘要

现代文明医疗体系面临的最大负担之一是心血管疾病(CVD)。因此,医学界正在寻找降低心血管疾病发病率的方法。从不健康生活方式转变为健康生活方式这种简单的生活方式改变是预防的基石,但心血管疾病的其他风险因素目前也成为了目标,最显著的是血脂异常。众所周知,降低血清脂质水平,尤其是降低升高的低密度脂蛋白胆固醇(LDL-胆固醇),可减少主要心血管事件。尽管迄今为止的重点一直是LDL-胆固醇水平并用他汀类药物降低该水平,但这往往还不够,因为血清中其他脂蛋白颗粒浓度增加以及存在残余心血管风险。由于在大多数情况下降低LDL-胆固醇水平是成功的,近期的重点已转向降低残余心血管风险。近年来,出现了针对富含甘油三酯的脂蛋白、脂蛋白(a)以及载脂蛋白C和B的新治疗选择。这些药物对严重不良心血管事件的影响尚不清楚,但近期对其中一些药物的研究已显示在降低总脂质水平方面取得了显著成果。本综述的目的是介绍目前治疗血脂异常的治疗选择,并描述新批准的药物以及仍在研发中的药物。尽管在现阶段我们不能肯定地说这些药物是否会被批准并广泛使用,但可以肯定地说,我们对血脂异常治疗的看法肯定正在发生变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5681/10531957/314dc711b1ce/jcm-12-05839-g001.jpg

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