New horizons in combination drug therapy for hypercholesterolemia.

New horizons in combination drug therapy for hypercholesterolemia.
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高胆固醇血症联合药物治疗的新视野。

DOI:
10.1159/000174550
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发表时间:
1989
期刊:
影响因子:
1.9
通讯作者:
Illingworth,DR
Illingworth,DR
中科院分区:
医学4区
文献类型:
--
作者:
Illingworth,DR

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目前有少量降血脂药物可用,它们作为单一药物使用往往无法充分控制患有严重高胆固醇血症的患者。联合用药方案提供了机会,最大限度地发挥具有不同作用机制的药物的降胆固醇效果,同时将潜在的副作用降至最低。胆汁酸隔离剂(胆碱胺和Colestiol)可增加粪便中的类固醇排泄,并且是非全身作用的;它们为大多数已建立的联合用药方案提供了基石。最有效的方案是将胆汁酸隔离剂与烟酸或最近使用的洛伐他汀或辛伐他汀联合使用。非诺贝特、苯扎贝特或普罗布考与胆碱胺或Colestiol联合使用也被证明是有用的,尽管普罗布考的低密度脂蛋白降低效果似乎非常不同。使用低剂量的胆汁酸隔离剂(每天4-8克胆碱胺或5-10克/天的可乐醇)与洛伐他汀、辛伐他汀或普罗布考联合使用提供了一种通常耐受性良好的治疗方案,表现出额外的降脂作用,并且具有成本效益。脂蛋白紊乱的治疗旨在降低已知的致动脉粥样硬化脂蛋白(低密度脂蛋白和极低密度脂蛋白残留物)的血浆浓度,同时降低动脉粥样硬化的发展速度。对于严重高甘油三酯血症的患者,饮食和药物治疗的目的也是控制或消除乳胶微粒血症,防止ab的发展。
A modest number of hypolipidemic drugs are currently available, and their use as single agents frequently fails to adequately control patients with severe hypercholesterol emia. Combined-drug regimens afford the opportunity to maximize the cholesterol-lowering effects of drugs that have different mechanisms of action and, at the same time, minimize potential side effects. The bile acid sequestrants (cholestyramine and colestipol) enhance fecal sterol excretion and are nonsystemically acting; they have provided the cornerstone for the majority of the established combined-drug regimens. The most effective regimens have used bile acid sequestrants in combination with nicotinic acid, or more recently, lovastatin or simvastatin. Combinations in which fenofibrate, bezafibrate, or probucol have been used with cholestyramine or colestipol have also been shown to be useful although the low-densi ty-lipoprotein-lowering effect of probucol appears quite variable. The use of low doses of bile acid sequestrants (4-8 g/day of cholestyramine or 5-10 g/day of colestipol) in combination with lovastatin, simvastatin, or probucol provides a therapeutic regimen that is usually well tolerated, shows additive lipid lowering, and is cost effective.Treatment of lipoprotein disorders aims to reduce the plasma concentrations of known atherogenic lipoproteins (low-density lipoprotein [LDL] and very-low-density li poprotein [VLDL] remnants) with a subse quent reduction in the rate of development of atherosclerosis. For patients with severe hypertriglyceridemia, diet and drug therapy also aim to control or eliminate chylomicronemia and avert the development of ab
DOI: 10.1111/j.1432-1033.1983.tb07575.x
发表时间: 1983
期刊: European journal of biochemistry
影响因子: --
作者:
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DOI: --
发表时间: 1989
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DOI: 10.1677/joe.0.117r001
发表时间: 1988
期刊: The Journal of endocrinology
影响因子: --
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DOI: --
发表时间: 1978
期刊:
影响因子: --
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