动脉粥样硬化性心血管疾病的药物治疗研究进展

Progress of Research on Drug Therapy of Atherosclerotic Cardiovascular Disease

动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular disease,ASCVD)患病率的快速增长是国内心血管疾病的重要特征。尽管已知多个因素包括家族遗传、生活方式和饮食习惯等与ASCVD的病理过程相关,但其发病机制尚不明确。目前临床对ASCVD的传统干预手段是以低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)为靶标的降脂药物治疗。近年来,前蛋白转化酶枯草溶菌素9(proprotein convertase subtilisin/kexin type 9,PCSK9)单抗等药物的出现使降脂治疗焕发新的“生机”。一些抗炎药物在临床试验中显著降低ASCVD患者心血管事件发生的风险,亦展现出了极大的开发潜力。此外,越来越多的研究从表观遗传的角度来阐明ASCVD的发病机制,发掘出了许多治疗靶点。综述这些药物以及相关靶点的研究进展,为未来的ASCVD临床药物治疗探索方向。

The rapidly increasing prevalence of atherosclerotic cardiovascular disease(ASCVD)is an important feature of cardiovascular disease in China.Though the development of ASCVD has been known to be associated with familial inheritance,lifestyle,and dietary habit,the pathogenesis of ASCVD is still unclear.The traditional clinical intervention for ASCVD is lipid-lowering drug therapy targeting lowdensity lipoprotein cholesterol(LDL-C).In recent years,the emergence of drugs such as proprotein convertase subtilisin/kexin type 9(PCSK9)monoclonal antibody has brought a new“hope”to lipid-lowering treatment.Moreover,some anti-inflammatory drugs have significantly reduced the risk of cardiovascular events in patients with ASCVD in clinical trials,showing their great potential for the treatment of ASCVD.Furthermore,more and more research has clarified the pathogenesis of ASCVD from the perspective of epigenetics,and has discovered many therapeutic targets.This review describes the research progress of these drugs and related targets,in the hope of exploring new direction of clinical drug treatment for ASCVD in the future.