摘要
目的高血脂是导致冠心病的主要因素,调节血脂到适当范围,能显著降低心血管事件的发生率。本文综述了近年来用于临床的降脂药物,降脂药物的联合应用以及新的药物作用靶点。为临床合理选择提供参考。方法参阅国内外大量相关文献,进行归纳和总结。结果按药物不同的作用特点可分为:胆固醇生物合成酶抑制剂、苯氧酸类、烟酸类、胆固醇吸收抑制剂、胆酸螯合剂、多不饱和脂肪酸类、其他非中药类以及中药类的降血脂药物。他汀类药物使用广泛,占据降血脂药物市场的60%,它是血脂异常治疗的基线和主线药物。结论目前,临床调脂是以降低血浆LDL-C水平为第一目标,他汀类药物是降低LDL-C幅度最大的药物。贝特类是降低血中三酰甘油最显著的。在升高HDL-C水平方面,烟酸类仍然是效果最突出的药物。临床有他汀类联合贝特类、烟酸类或依折麦布应用,但目前的研究还不能证明联合应用较单用他汀,心血管事件发生率减少。联合用药只是二线选择。在生活方式的改善、饮食治疗、体育锻炼的基础上,有针对性的选用降脂药物,不仅医学指标显著降低,而且大大减少CV事件的发生。
Objective Hyperlipidemia is a leading cause of coronary heart disease,regulation of blood lipids to the proper scope,can significantly reduce the incidence of cardiovascular events.This article reviews recent used in clinical medicine,lipid-lowering drug combination as well as new targets of drug action.The rational choice to provide reference.Methods Refer to the literatures,and summarize the summary.Results According to the different characteristics of drug action can be divided into： cholesterol biosynthesis inhibitors,phenoxy acid,nicotinic acid,cholesterol absorption inhibitors,cholic acid chelating agent,polyunsaturated fatty acids,other than the category of traditional Chinese medicine and traditional Chinese medicine class of hypolipidemic drugs.Statin use is extensive,occupy the hypolipidemic drug market in 60%,it is the treatment of dyslipidemia in baseline and the main drug.Conclusion At present,clinical lipid regulation is to reduce plasma LDL-C levels for the first goal,statins are reduced LDL-C range is the biggest drug.Fibrates reducing the triglyceride in blood is the most significant.In the elevated HDL-C levels,nicotinic acid is still the most prominent drug effect.The clinical of statins in combination fibrate,nicotinic acid or ezetimibe application,but the current research cannot prove that combined application of than the single use of statins,cardiovascular event rate reduction.Combined medication only second-line choice.In the change of way of life,diet therapy,exercise basis,targeted use of lipid-lowering drugs,not only medical index decreased significantly,but also greatly reduces the CV events.
出处
《中国医药指南》
2012年第34期95-99,共5页
Guide of China Medicine
关键词
血脂异常
他汀
贝特类药物
烟酸类药物
依折麦布
联合调脂
酰基辅酶A-胆固醇酰基转移酶
胆固醇酯转移蛋白
磷脂转移蛋白
Lipid abnormalities
Statin
fibrates
Nicotinic acid drugs
Ezetimibe
Combined lipid lowering
Acyl coenzyme A
Cholesterol acyltransferase
Cholesterol ester transfer protein
Phospholipid transfer protein
