升高高密度脂蛋白胆固醇药物的相关研究进展

The Research Progress of Increasing High-Density Lipoprotein Cholesterol

目前已有流行病学资料明确提示,高密度脂蛋白胆固醇(HDL-C)水平与冠心病危险性呈负相关,低水平的HDL-C已被公认为动脉粥样硬化性疾病的独立危险因素之一。通过药物使HDL-C升高能否进一步降低心血管疾病的发病风险已成为近些年来临床试验关注的焦点。本文对目前已应用于临床或正在研究的具有升高HDL-C作用的四类药物,即他汀类、贝特类、烟酸及胆固醇酯转运蛋白(CETP)抑制剂的主要作用机制、临床研究进展等进行归纳和总结。其中,烟酸及CETP抑制剂升高HDL-C作用显著,尽管目前针对这两类药物的临床证据仍然较为匮乏,但有理由相信正在进行的几项国际大规模临床试验将为此提供重要的询证医学证据,其结果值得期待。

Several cross-sectional and prospective epidemiological studies have demonstrated that high-density lipoprotein cholesterol(HDL-C)is a strong inverse predictor of coronary heart disease(CHD),and low level of HDL-C is an independent risk factor of atherosclerotic diseases.It has become the focus of recent clinical trials whether increasing HDL-C concentration by drugs can reduce the risk of cardiovascular diseases.This article will summarize and discuss four kinds of drugs that currently used in clinical or on study for increasing HDL-C.Among them niacin and CETP inhibitor have great efficiency for raising HDL-C.Although clinical evidence for these two drugs are still relatively scarce,it is believed that the ongoing international large-scale clinical trials will provide important medical evidence.