摘要
以低密度脂蛋白胆固醇(Low-density lipoprotein cholesterol,LDL-C)为代表的致动脉粥样硬化脂蛋白是动脉粥样硬化性心血管疾病(Atherosclerotic cardiovascular disease,ASCVD)的致病性危险因素,近年来世界范围内血脂领域的研究取得了突破性进展,推动了血脂指南的更新,«中国血脂管理指南(2023年)»(以下简称新版«指南»)仍推荐LDL-C作为血脂干预的首要靶点,以危险分层确定其目标值,同时在糖尿病、代谢综合征以及极低LDL-C人群中强调非高密度脂蛋白胆固醇达标,新版«指南»推荐降脂治疗策略以生活方式干预为基础、中等强度他汀类药物作为起始药物治疗,必要时联用胆固醇吸收抑制剂和/或前蛋白转化酶枯草溶菌素9抑制剂实现血脂达标,另外,新版«指南»涵盖了从儿童到老年全生命周期的血脂管理建议,我们针对新版«指南»的核心内容进行解读,推动指南指导临床实践,以全面提升我国血脂管理及ASCVD防治水平。
Proatherogenic lipoproteins represented by low-density lipoprotein cholesterol(LDL-C)have been demonstrated as pathogenic and core risk factor for atherosclerotic cardiovascular disease(ASCVD).Recent worldwide advances in dyslipidemia-based evidences have greatly speeded up the update of the management guidelines for dyslipidemia.“China Guidelines for Lipid Management(2023)”hereinafter referred to as the new guidelines.The new guidelines continuously recommend LDL-C as the primary intervention target,meanwhile,the achievement goal of non-high-density lipoprotein cholesterol was emphasized in populations with diabeties,metabolic syndrome and very low LDL-C level.For the treatment strategy of blood lipid,based on the therapeutic life intervention,moderate strength of statins should be the first choice,if necessary,with cholesterol absorption inhibitor and/or proprotein convertase subtilisin/kexin type 9 inhibitor to realize the goal.Moreover,the new guidelines completely covered the recommendations of blood lipid management for the whole life-span.We focused on the interpretation of key messages of the new guidelines,promoted the guidelines to guide practice,thereby improving the overall level of blood lipid management and ASCVD prevention in China.
作者
张大庆
Zhang Daqing(Department of Cardiology,Shengjing Hospital of China Medical University,Shenyang 110004,China)
出处
《实用药物与临床》
CAS
2023年第5期385-389,共5页
Practical Pharmacy and Clinical Remedies
关键词
动脉粥样硬化性心血管疾病
血脂
管理
他汀类药物
联合治疗
指南解读
Atherosclerotic cardiovascular disease
Blood lipid
Management
Statins
Combined therapy
Guidelines interpretation
