Rosenson R S
Preventive Cardiology Center, Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill.
Arch Intern Med. 1993 Jul 12;153(13):1528-38.
Clinical management of dyslipidemias has focused primarily on the low-density lipoprotein cholesterol (LDL-C) fraction; however, lipid disorders accompanied by low levels of high-density lipoprotein cholesterol (HDL-C) (hypoalphalipoproteinemia) are common, particularly among subjects with the diagnosis of coronary artery disease prior to age 55 years. The therapeutic objectives for high-risk subjects with dyslipidemias is directed initially toward reduction of the LDL-C fraction; thereafter, aggressive efforts aimed at raising the HDL-C fraction may be warranted. Strategies for raising the HDL-C fraction start with hygienic measures that include aerobic exercise, weight loss, smoking cessation, withdrawal of agents secondarily lowering HDL-C, and estrogen replacement. Pharmacotherapy selected according to the dyslipidemia that accompanies the HDL-C disorder is indicated for subjects who manifest premature coronary artery disease or who have a familial history of coronary artery disease and hypoalphalipoproteinemia.
血脂异常的临床管理主要集中在低密度脂蛋白胆固醇（LDL-C）部分；然而，伴有高密度脂蛋白胆固醇（HDL-C）水平降低（低α脂蛋白血症）的脂质紊乱很常见，尤其是在55岁之前被诊断为冠状动脉疾病的患者中。血脂异常高危患者的治疗目标最初是降低LDL-C部分；此后，可能需要积极努力提高HDL-C部分。提高HDL-C部分的策略首先从卫生措施开始，包括有氧运动、减肥、戒烟、停用继发性降低HDL-C的药物以及雌激素替代。对于患有早发性冠状动脉疾病或有冠状动脉疾病家族史和低α脂蛋白血症的患者，根据伴随HDL-C紊乱的血脂异常选择药物治疗。
