Hunninghake D B
Am J Med. 1983 May 23;74(5A):19-22.
Drug therapy should be instituted only after appropriate diet treatment has been started and adequate baseline lipid and lipoprotein values are established. Nicotinic acid is useful in treating most lipoprotein disorders and the cutaneous flushing that develops during the early part of treatment is usually alleviated by aspirin. Cholestyramine and colestipol are nonabsorbable resins whose use is limited to type II hyperlipoproteinemia. Clofibrate is primarily effective in lowering triglyceride levels, but its clinical use has considerably declined following the World Health Organization study results that reported increased morbidity and mortality rates among patients receiving this drug. Based on the finding of increased mortality among a subset of patients participating in the Coronary Drug Project, dextrothyroxine is only recommended for treating patients who do not have clinically evident atherosclerotic heart disease. Probucol lowers total and low-density lipoprotein cholesterol levels, but has the undesirable effect of simultaneously reducing high-density lipoprotein levels.
只有在开始适当的饮食治疗并确定了足够的基线血脂和脂蛋白值之后，才应开始药物治疗。烟酸对治疗大多数脂蛋白紊乱有效，治疗早期出现的皮肤潮红通常可通过阿司匹林缓解。考来烯胺和考来替泊是不可吸收的树脂，其应用仅限于II型高脂蛋白血症。氯贝丁酯主要有效降低甘油三酯水平，但根据世界卫生组织的研究结果，其临床应用已大幅下降，该研究报告接受此药的患者发病率和死亡率增加。基于参与冠心病药物项目的一部分患者死亡率增加的发现，右旋甲状腺素仅推荐用于治疗无临床明显动脉粥样硬化性心脏病的患者。普罗布考可降低总胆固醇和低密度脂蛋白胆固醇水平，但有同时降低高密度脂蛋白水平的不良作用。
