Foubert L, Dejager S, Bruckert E, Turpin G
Service d'Endocrinologie-Métabolisme, Hôpital de la Pitié, Paris.
Ann Endocrinol (Paris). 1997;58(4):275-82.
Hyperlipidemia, particularly hypercholesterolemia, is a well established risk factor for cardiovascular disease, specially coronary heart disease. Lipid-lowering therapies are associated with a reduction in cardiovascular morbidity and mortality in secondary as well as primary prevention. A precise lipid pattern is necessary before any treatment. The target level depends on the clinical data and associated cardiovascular risk factors. Diet is the first step approach and should always be continued. Cholestyramine and statins are the treatments of choice in case of hypercholesterolemia (type IIa). In case of isolated or associated hypertriglyceridemia (types IV and IIb) fibrates are the most efficient. No treatment is really efficient on Lp(a) level. A good observance is required for a lifelong treatment.
高脂血症,尤其是高胆固醇血症,是心血管疾病,特别是冠心病的一个公认的危险因素。降脂治疗与二级和一级预防中心血管发病率和死亡率的降低相关。在进行任何治疗之前,需要明确血脂谱。目标水平取决于临床数据和相关的心血管危险因素。饮食是首要的治疗方法,应始终坚持。对于高胆固醇血症(IIa型),考来烯胺和他汀类药物是首选治疗药物。对于单纯性或合并性高甘油三酯血症(IV型和IIb型),贝特类药物最为有效。目前尚无真正能有效降低脂蛋白(a)水平的治疗方法。终身治疗需要良好的依从性。