内毒素 - 脂蛋白假说
M Rauchhaus1, A J Coats, S D Anker
1Department of Clinical Cardiology, National Heart and Lung Institute, London, UK. m.rauchhaus@ic.ac.uk
Lancet (London, England)
|October 19, 2000
概括
类药物降低胆固醇,但可能会伤害慢性心力衰竭 (CHF) 患者. 较高的胆固醇可能通过结合有害的脂多糖化合物在CHF中有益,这表明非降脂类他类药物可能是有利的.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学 是一个学科.
背景情况:
- 类他类药物 (3-基-3-甲基氨酸-共酶A减少酶抑制剂) 彻底改变了高胆固醇血症的治疗方法,降低了心血管疾病的发病率和死亡率.
- 西姆瓦斯塔丁可以减少心力衰竭的新发病,但它的好处可能不仅仅是降低脂质.
- 低血清胆固醇与慢性心力衰竭 (CHF) 患者的存活率受损有关,可能是由于炎症和脂多糖的增加.
研究的目的:
- 研究CHF患者中较高总胆固醇度的潜在益处.
- 为了探索脂蛋白与脂聚糖结合,减轻有害影响的假设.
- 提出非降脂类他类药物的特性 (免疫调节,抗炎) 可能对CHF有益.
主要方法:
- 关于他类药物对心血管疾病和CHF的影响现有证据的审查.
- 假设一种机制,涉及脂蛋白与脂聚糖的结合.
- 假设一个最佳的脂蛋白度为CHF患者.
主要成果:
- 有证据表明,降低胆固醇可能对心血管疾病有害.
- 脂蛋白可能会结合脂多糖,提供保护作用.
- 存在潜在的值,低于此,降脂可能是有害的.
结论:
- 在CHF患者中,较高的总胆固醇度可能有益.
- 脂蛋白在结合脂聚糖的作用需要进一步研究.
- 具有免疫调节性质的非降脂类他类药物可以在CHF中提供治疗优势.
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