论文部分内容阅读
述评目的流行病学研究已经表明血浆HDL-胆固醇与冠状动脉疾病成负相关。HDL-胆固醇和甘油三酯也呈负相关,但是现在证明高甘油三酯症是冠心病的独立危险因素。本文的目的是讨论甘油三酯和HDL-胆固醇是否能够作为降低心血管病危险性的治疗靶点。近来的发现甘油三酯的测定对于确定血浆中富含甘油三酯的脂蛋白的特异性没有多大的意义,因为一些脂蛋白(如乳糜微滴、大的极低密度脂蛋白(VLDL)是不导致动脉粥样硬化的,而另一些脂蛋白(如小的VLDL、乳糜残粒、中密度脂蛋白等)可以导致动脉粥样硬化。他汀类药物除了可以降低低密度脂蛋白(LDL)胆固醇外,还能够明显的降低可以导致动脉粥样硬化的残留脂蛋白胆固醇的水平。4S、CARE+LIPID和AFCAPS/TexCAPS研究提示他汀类药物能增加治疗功效,改善冠心病患者甘油三酯和HDL-胆固醇水平。在对冠心病体征HDL-胆固醇男性二级预防试验中发现:贝特类药物(吉非罗齐)可以降低冠心病死亡和非致命性心肌梗死。在治疗过程中,各种胆固醇和甘油三酯的水平可以用来表示冠心病事件危险性的数量级。小结ATPIII(成人治疗组)建议:对甘油三酯和HDL-胆固醇作为降低心血管病危险性靶点的:1)降低LDL-胆固醇的水平是治疗的主要目标;2)二级目标是将甘油三酯的水平控制在150mg/dl以下;3)即使HDL-胆
REVIEW PURPOSE Epidemiological studies have shown that plasma HDL-cholesterol is negatively correlated with coronary artery disease. HDL-cholesterol and triglycerides are also negatively correlated, but hypertriglyceridemia is now proven to be an independent risk factor for coronary heart disease. The purpose of this article is to discuss whether triglycerides and HDL-cholesterol can be used as therapeutic targets to reduce the risk of cardiovascular disease. Recent findings of triglyceride determination are not of much significance in determining the specificity of triglyceride-rich lipoproteins in plasma, as some lipoproteins (eg, chylomicron, large very low density lipoprotein (VLDL) Lead to atherosclerosis, while other lipoproteins (such as small VLDL, chylomicrons, middle density lipoprotein, etc.) can lead to atherosclerosis.Statins in addition to lower low-density lipoprotein (LDL) cholesterol , But also significantly reduce the level of residual lipoprotein cholesterol that can lead to atherosclerosis.Studies on 4S, CARE + LIPID and AFCAPS / TexCAPS suggest that statins may increase therapeutic efficacy and improve triglyceride and HDL-cholesterol levels in patients with coronary heart disease Level in patients with signs of coronary heart disease HDL-cholesterol male secondary prevention trials found that: fibrates (gemfibrozil) can reduce coronary heart disease death and non-fatal myocardial infarction in the course of treatment, a variety of cholesterol and glycerol Triester levels can be used to indicate the magnitude of the risk of coronary events. Summary ATPIII (adult treatment group) recommends that triglycerides and HDL-cholesterol be used as agents for reducing cardiovascular risk Risk Targets: 1) Lowering LDL-cholesterol levels is the primary goal of treatment; 2) Secondary goals are to control triglyceride levels below 150 mg / dl; 3) Even though HDL-