Shepherd J
Institute of Biochemistry, Royal Infirmary, Glasgow, Scotland, UK.
Int J Gynaecol Obstet. 1995 Sep;50 Suppl 1:S23-6. doi: 10.1016/0020-7292(95)02511-a.
The potential long-term impact of danazol on coronary risk hinges on its effect on lipoprotein metabolism rather than its influence on total plasma lipids. Danazol may exert a regulatory influence on three key processes in lipoprotein metabolism: hepatic lipase activity; low-density lipoprotein receptor function; and lecithin:cholesterol acyl-transferase activity. Danazol decreases plasma fibrinogen and lipoprotein (a) levels, promotes fibrinolysis and causes a rise in plasminogen. Such changes are beneficial as they inhibit the process of thrombosis. Androgenic properties of danazol produce effects of plasma lipids and lipoproteins which oppose estrogen-induced changes. The usual recipients of danazol therapy are premenopausal females, in whom the absolute risk of ischemic heart disease is low. If the drug were shown to increase ischemic heart disease risk, detrimental factors must be weighted against its considerable and proven clinical benefits.
达那唑对冠心病风险的潜在长期影响取决于其对脂蛋白代谢的作用，而非对总血浆脂质的影响。达那唑可能对脂蛋白代谢的三个关键过程产生调节作用：肝脂酶活性、低密度脂蛋白受体功能以及卵磷脂胆固醇酰基转移酶活性。达那唑可降低血浆纤维蛋白原和脂蛋白(a)水平，促进纤维蛋白溶解并使纤溶酶原水平升高。这些变化是有益的，因为它们抑制血栓形成过程。达那唑的雄激素特性会产生与雌激素诱导变化相反的血浆脂质和脂蛋白效应。达那唑治疗的常见对象是绝经前女性，她们患缺血性心脏病的绝对风险较低。如果该药物被证明会增加缺血性心脏病风险，那么必须在有害因素与它已被证实的显著临床益处之间进行权衡。
