降低血清脂蛋白a水平的治疗现状与进展

何雪纯; 文智颖; 郑颖颖

doi:10.16766/j.cnki.issn.1674-4152.004013

降低血清脂蛋白a水平的治疗现状与进展

doi: 10.16766/j.cnki.issn.1674-4152.004013

新疆医科大学第一附属医院心脏中心心力衰竭科，新疆乌鲁木齐 830000

基金项目:

新疆维吾尔自治区自然科学基金项目 2022D01E70

详细信息

通讯作者:
郑颖颖，E-mail：zhengying527@163.com

中图分类号: R54 R589.2
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出版历程
- 收稿日期: 2024-05-16
- 网络出版日期: 2025-08-14

Current status and advances in the treatment of lowering serum lipoprotein a levels

Department of Heart Failure, Heart Center, the First Affiliated Hospital of Xinjiang

摘要

摘要: 心血管疾病(CVD)仍在全球人群中有着严重的负担，具有高发病率、病死率等特点。尽管目前已有多种治疗方式对心血管危险因素进行管理，但残余心血管风险发生率仍未得到改善，寻找新的CVD风险干预靶点成为新的研究热点之一。其中，脂蛋白代谢紊乱是继血压升高的第二大归因危险因素，而低密度脂蛋白胆固醇(LDL-C)作为主要血脂干预目标，目前市场上已有多种不同类型药物对LDL-C进行调控。但研究仍提示，即使LDL-C已达到临床指南所推荐的目标值，进一步随访发现CVD仍有进展，残余心血管风险、主要心血管事件(MACE)发生率仍未有明显改善。脂蛋白a[Lp(a)]与LDL-C结构相似，但较后者有着更强致炎、致粥样硬化特性，使其成为近年来最受关注的血脂类型之一。目前Lp(a)已明确为动脉粥样硬化性心血管疾病(ASCVD)危险因素，但多数以LDL-C为干预靶点的降脂药物对Lp(a)作用影响不明确，而针对Lp(a)的新药临床试验尚在开展中。研究对于Lp(a)的有效治疗仍不清晰，因此本文就目前临床及研究中可用的主要降脂治疗对Lp(a)的影响进行综述，并进一步讨论有关新兴疗法。
- 心血管疾病 /
- 脂蛋白a /
- 高脂血症 /
- 血脂治疗
Abstract: Cardiovascular disease (CVD) remains a serious burden in the global population, characterized by high morbidity and mortality. Despite the availability of multiple ways to manage cardiovascular risk factors, the incidence of residual cardiovascular risk has not improved, and the search for new targets for CVD risk intervention has become one of the new research hotspots. Lipoprotein metabolic disorder is the second most important attributable risk factor besides high blood pressure, with low-density lipoprotein cholesterol (LDL-C) as the main target, and there are several types of different drugs on the market to modulate LDL-C. However, as the fact that LDL-C has reached the targets recommended by clinical guidelines, the associated disease progression and the incidence of residual cardiovascular risk and major adverse cardiovascular events (MACE) have not improved. Lipoprotein(a) [Lp(a)] is structurally similar to LDL-C, but has stronger inflammatory and atherogenic properties than the latter, making it one of the most talked about lipid types in recent years. Although Lp(a) has been identified as an important risk factor for atherosclerotic cardiovascular disease (ASCVD), but the effects of most lipid-lowering drugs targeting LDL-C are unknown, and clinical trials of new drugs for Lp(a) are still underway. Research remains unclear for effective treatment of Lp(a), and this article provides an overview of the effects of the major lipid-lowering tools currently available in clinical and research settings on Lp(a) levels, and further discusses emerging therapies.
- Cardiovascular disease /
- Lipoprotein(a) /
- Hypertriglyceridemia /
- Lipid therapy

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参考文献(36)

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