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Review Article

降低胆固醇的三大利器:他汀类药物，依折麦布和依伏库单抗

卷 28, 期 5, 2021

发表于: 05 May, 2020

页: [1025 - 1041] 页: 17

弟呕挨: 10.2174/0929867327666200505091738

价格: $65

摘要

冠心病与高胆固醇血症密切相关，降低血清胆固醇是目前降低冠心病最重要的策略。在人体内，血清胆固醇水平主要是由三条代谢途径决定的，即膳食中胆固醇的摄入、胆固醇的合成和体内胆固醇的降解。针对三种途径的关键分子进行干预是降低血脂的重要策略。他汀类药物可抑制3-羟基-3-甲基戊二酰辅酶A还原酶(HMG-CoA还原酶)，使低密度脂蛋白(LDL)降低约20%至45%。然而，高达15%的患者不能忍受高剂量他汀类药物的潜在副作用，一些患者在接受他汀类药物治疗后仍不能达到其理想的LDL目标。依折麦布通过靶向Niemann-Pick C1-like 1蛋白(NPC1L1)来抑制胆固醇吸收，该蛋白与胆固醇在肠道中的吸收有关。依折麦布单独使用时可降低约18%的LDL，与他汀联合使用时可额外降低25%。原蛋白转化酶枯草素/可心9型(PCSK9)增加肝脏低密度脂蛋白的降解，从而降低肝脏清除低密度脂蛋白的能力，从而导致高胆固醇血症。Evolocumab是PCSK9单克隆抗体，可将LDL从基线水平降低53%至56%。这三种药物通过调节脂质代谢的三个关键通路发挥降脂作用。any在他汀治疗的基础上与其他两种药物联合使用，提高了降脂效果。三者结合是否能减少单药治疗的副作用，达到降脂的效果还有待进一步研究。

关键词: 冠心病，高胆固醇血症，胆固醇代谢，他汀类药物，依折麦布，依伏库单抗

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