李建军

• 1:国家心血管病中心 阜外心血管病医院 心血管疾病国家重点实验室 血脂异常与心血管病诊治中心

摘要(Abstract)：

<正>降低胆固醇在心血管疾病防治中发挥着极为重要的作用,血脂异常的首要干预目标是降低低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)。他汀20余年的发展和大量的循证医学证据奠定了其成为调脂治疗的基石和降LDL-C的首选药物[1,2]。他汀类药物的系列研究显示,LDL-C在一定范围内"低一点更好"。但人类至今尚未找到LDL-C安全而有效的确切靶目标,是否存在类似血压和血糖的"J"型曲线尚待阐明。因而学术界对降LDL-C治疗的目标值最低下限尚需进一

关键词(KeyWords)：

Abstract:

Keywords:

基金项目(Foundation): 首都临床特色应用研究(Z121107001012015);; 首都医学发展科研基金(2011400302);; 北京市自然科学基金(7131014)

作者(Author): 李建军

参考文献(References)：

• [1]Li JJ,Luo ZL,Kou WR,et al.Impact of Xuezhikang on coronary events in hypertensive patients with previous myocardial infarction from Chinese Coronary Secondary Prevention Study(CCSPS)[J].Ann Med,2010,42(3):231-240.
• [2]Guo YL,Liu J,Li JJ,et al.A multi-center survey of achieving recommended lipid goals in Chinese patients with coronary artery disease in real world cardiovascular practice[J].Int J Cardiol,2011,153(2):211-212.
• [3]Moreno JJ,Mitjavila MT.The degree of unsaturation of dietary fatty acids and the development of atherosclerosis(review)[J].J Nutr Biochem,2003,14(4):182-195.
• [4]SteinerováA,Racek J,Stozicky F,et al.Antibodies against oxidized LDL-theory and clinical use[J].Physiol Res,2001,50(2):131-141.
• [5]Castrillo A,Tontonoz P.PPARs in atherosclerosis:the clot thickens[J].J Clin Invest,2004,114(11):1538-1540.
• [6]Ross R.Atherosclerosis-an inflammatory disease[J].N Engl J Med,1999,340(2):115-126.
• [7]Panel NE.Summary of the second report of the National Cholesterol Education Program(NCEP)Expert Panel on Detection,Evaluation,and Treatment of High Blood Cholesterol in Adults(Adult Treatment PanelⅡ)[J].JAMA,1993,269(23):3015-3023.
• [8]Baigent C,Keech A,Kearney PM,et al.Efficacy and safety of cholesterol-lowering treatment:prospective meta-analysis of data from 90 056 participants in 14 randomised trials of statins[J].Lancet,2005,366(9493):1267-1278.
• [9]Forrester JS.Redefining normal low-density lipoprotein cholesterol:a strategy to unseat coronary disease as the nation's leading killer[J].J Am Coll Cardiol,2010,56(8):630-636.
• [10]Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels.The Long-Term Intervention with Pravastatin in Ischaemic Disease(LIPID)Study Group[J].N Engl J Med,1998,339(19):1349-1357.
• [11]Sacks FM.The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels.Cholesterol and Recurrent Events Trial investigators[J].N Engl J Med,1996,335(14):1001-1009.
• [12]Shepherd J,Cobbe SM,Ford I,et al.Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia.West of Scotland Coronary Prevention Study Group[J].N Engl J Med,1995,333(20):1301-1307.
• [13]Downs JR,Clearfield M,Weis S,et al.Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels:results of AFCAPS/TexCAPS.Air Force/Texas Coronary Atherosclerosis Prevention Study[J].JAMA,1998,279(20):1615-1622.
• [14]Expert Panel on Detection,Evaluation,and Treatment of High Blood Cholesterol in Adults.Executive Summary of The Third Report of The National Cholesterol Education Program(NCEP)Expert Panel on Detection,Evaluation,And Treatment of High Blood Cholesterol In Adults(Adult Treatment PanelⅢ)[J].JAMA,2001,285(19):2486-2497.
• [15]Heart Protection Study Collaborative Group.Heart Protection Study of cholesterol lowering with simvastatin in 20,536 highrisk individuals:a randomised placebo-controlled trial[J].Lancet,2002,360(9326):7-22.
• [16]Wiviott SD,Cannon CP,Morrow DA,et al.Can low-density lipoprotein be too low?The safety and efficacy of achieving very low low-density lipoprotein with intensive statin therapy:a PROVE IT-TIMI 22 substudy[J].J Am Coll Cardiol,2005,46(8):1411-1416.
• [17]Grundy SM,Cleeman JI,Merz CN,et al.Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment PanelⅢguidelines[J].Circulation,2004,110(2):227-239.
• [18]Ridker PM,Danielson E,Fonseca FA,et al.Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin:a prospective study of the JUPITER trial[J].Lancet,2009,373(9670):1175-1182.
• [19]Nissen SE,Tuzcu EM,Schoenhagen P,et al.Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis:a randomized controlled trial[J].JAMA,2004,291(9):1071-1080.
• [20]Cholesterol Treatment Trialists C,Mihaylova B,Emberson J,et al.The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease:meta-analysis of individual data from 27 randomised trials[J].Lancet,2012,380(9841):581-590.
• [21]European Association for Cardiovascular Prevention&Rehabilitation,Reiner Z,Catapano AL,et al.ESC/EAS Guidelines for the management of dyslipidaemias:the Task Force for the management of dyslipidaemias of the European Society of Cardiology(ESC)and the European Atherosclerosis Society(EAS)[J].Eur Heart J,2011,32(14):1769-1818.
• [22]李红娟,刘军,刘静,等.他汀类药物在中国极高危冠心病患者二级预防中的应用现况[J].中华心血管病杂志,2010,38(11):1033-1039.
• [23]Gitt AK,Drexel H,Feely J,et al.Persistent lipid abnormalities in statin-treated patients and predictors of LDL-cholesterol goal achievement in clinical practice in Europe and Canada[J].Eur J Prev Cardiol,2012,19(2):221-230.
• [24]Pedro-Botet J,Schaefer EJ,Bakker-Arkema RG,et al.Apolipoprotein E genotype affects plasma lipid response to atorvastatin in a gender specific manner[J].Atherosclerosis,2001,158(1):183-193.
• [25]van Himbergen TM,Matthan NR,Resteghini NA,et al.Comparison of the effects of maximal dose atorvastatin and rosuvastatin therapy on cholesterol synthesis and absorption markers[J].J Lipid Res,2009,50(4):730-739.
• [26]Nicholls SJ,Brandrup-Wognsen G,Palmer M,et al.Metaanalysis of comparative efficacy of increasing dose of Atorvastatin versus Rosuvastatin versus Simvastatin on lowering levels of atherogenic lipids(from VOYAGER)[J].Am J Cardiol,2010,105(1):69-76.
• [27]Barter PJ,O'Brien RC.Achievement of target plasma cholesterol levels in hypercholesterolaemic patients being treated in general practice[J].Atherosclerosis,2000,149(1):199-205.
• [28]Goldberg AC,Sapre A,Liu J,et al.Efficacy and safety of ezetimibe coadministered with simvastatin in patients with primary hypercholesterolemia:a randomized,double-blind,placebo-controlled trial[J].Mayo Clin Proc,2004,79(5):620-629.
• [29]Farnier M,Averna M,Missault L,et al.Lipid-altering efficacy of ezetimibe/simvastatin 10/20 mg compared with rosuvastatin10 mg in high-risk hypercholesterolaemic patients inadequately controlled with prior statin monotherapy-The IN-CROSS study[J].Int J Clin Pract,2009,63(4):547-559.
• [30]McCormack T,Harvey P,Gaunt R,et al.Incremental cholesterol reduction with ezetimibe/simvastatin,atorvastatin and rosuvastatin in UK General Practice(IN-PRACTICE):randomised controlled trial of achievement of Joint British Societies(JBS-2)cholesterol targets[J].Int J Clin Pract,2010,64(8):1052-1061.
• [31]Davidson MH,McGarry T,Bettis R,et al.Ezetimibe coadministered with simvastatin in patients with primary hypercholesterolemia[J].J Am Coll Cardiol,2002,40(12):2125-2134.
• [32]Ballantyne CM,Houri J,Notarbartolo A,et al.Effect of ezetimibe coadministered with atorvastatin in 628 patients with primary hypercholesterolemia:a prospective,randomized,double-blind trial[J].Circulation,2003,107(19):2409-2415.
• [33]Melani L,Mills R,Hassman D,et al.Efficacy and safety of ezetimibe coadministered with pravastatin in patients with primary hypercholesterolemia:a prospective,randomized,double-blind trial[J].Eur Heart J,2003,24(8):717-728.
• [34]Kerzner B,Corbelli J,Sharp S,et al.Efficacy and safety of ezetimibe coadministered with lovastatin in primary hypercholesterolemia[J].Am J Cardiol,2003,91(4):418-424.
• [35]Baigent C,Landray MJ,Reith C,et al.The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease(Study of Heart and Renal Protection):a randomised placebo-controlled trial[J].Lancet,2011,377(9784):2181-2192.
• [36]Stein EA,Mellis S,Yancopoulos GD,et al.Effect of a monoclonal antibody to PCSK9 on LDL cholesterol[J].N Engl J Med,2012,366(12):1108-1118.