家庭高胆固醇血症回归研究:一种低密度脂蛋白非的随机试验
G R Thompson1, V M Maher, S Matthews
1Department of Cardiology, Hammersmith Hospital, London.
Lancet (London, England)
|April 1, 1995
概括
与药物治疗相比,低密度脂蛋白 (LDL) 无症有效降低了LDL胆固醇和脂蛋白. 然而,它在改善冠状动脉样硬化的效果较小,这表明它应该保留给药物不耐受患者.
科学领域:
- 心脏病学 心脏病学
- 代谢障碍 代谢障碍 代谢障碍
- 药理学 药理学是指药理学的学科.
背景情况:
- 家族性高胆固醇血症对冠状动脉疾病具有显著的风险.
- 脂蛋白是动脉样硬化的一个独立风险因素.
- 理论上,LDL非瑞斯在降低LDL和脂蛋白方面都有优势,与他或树脂相比.
研究的目的:
- 为了比较LDL疏散加simvastatin与 colestipol加simvastatin在患有异性家族高胆固醇血症和冠状动脉疾病的患者中的疗效.
- 评估这些治疗对脂蛋白水平和冠状动脉样硬化进展的影响.
主要方法:
- 随机对照试验涉及异构卵性家族高胆固醇血症和冠状动脉疾病的患者.
- 治疗群体:LDL无光体 (每隔两天一次) + 西姆瓦斯塔丁 (每天40毫克) 与科莱斯蒂波尔 (每天20毫克) + 西姆瓦斯塔丁 (每天40毫克).
- 定量冠状动脉血管造影在基线和平均2.1年后进行,以评估冠状动脉样硬化的变化.
主要成果:
- 较于组合药物疗法,LDL非瑞斯显著降低了LDL胆固醇和脂蛋白.
- 在每位患者的初级血管造影终点中没有发现显著差异.
- 基于二次病变和基于细分的终点有利于药物治疗组,表明冠状动脉样硬化在药物治疗下进展较小.
结论:
- 虽然LDL疏散在降低LDL胆固醇和脂蛋白方面更有效,但与组合药物治疗相比,它在影响冠状动脉样硬化进展方面效果较差.
- 应该为患有家族性高胆固醇血症且对降脂药物无反应的患者保留LDL非瑞斯.
- 将LDL胆固醇降低到3.4mmol/L或更低可能会使进一步降低脂蛋白 (a) 无需用于治疗冠状动脉样硬化.
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