脂蛋白a与冠状动脉粥样硬化疾病的研究进展

Progress in lipoprotein(a)and coronary atherosclerosis

脂蛋白(lipoprotein)作为研究动脉粥样硬化疾病的常客,目前已得到广泛研究。而脂蛋白a[lipoprotein(a),Lp(a)]是一种密度介于高密度和低密度之间的特殊脂蛋白,与遗传因素息息相关。它富含载脂蛋白A(apolipoprotein A,apoA),可与胆固醇相结合,沉积于血管壁,促使动脉粥样硬化,形成血栓;它能促进血管炎症发生,影响斑块稳定性,是冠心病的独立风险因子。近年来随着对Lp(a)研究的深入,也出现了一批针对高Lp(a)疾病的降脂药物,科技和生物信息技术发展日新月异,对于Lp(a)的认识也在逐步提高。本文就Lp(a)结构、理化性质、与冠状动脉粥样硬化疾病之间的生物反应以及相关治疗药物的研究进展进行总结与阐述。

Lipoprotein(a)[Lp(a)]is a kind of liver-derived lipoprotein,which consists of apolipoprotein(apo)B100 covalently bound to apoA.Therefore,it has atherothrombotic traits of both apoB(from low-density lipoprotein)and apoA(thrombo-inflammatory aspects).Recent advances in clinical and genetic research have revealed the crucial role of Lp(a)in the pathogenesis of cardiovascular diseases.High Lp(a)concentration has long been linked to increased risk of coronary atherosclerotic disease(CAD).Although conventional pharmacological therapies have failed to significantly reduce Lp(a)level,emerging new therapeutic strategies using proprotein convertase subtilisin-kexin type 9 inhibitors have shown promising results in effectively lowering Lp(a).This review summarizes the recent advances in the role of Lp(a)in the pathogenesis of CAD and the related lipid-lowering drugs.