2型糖尿病血脂异常及治疗  

Treatment of Dyslipidemia in Type 2 Diabetes

作　　者：尹纯[1] 孙艺红[2] YIN Chun SUN Yihong(Chongqing Medical University, Chongqing 400016, China China-Japan Friendship Hospital ,Beijing 100029, China)

机构地区：[1]重庆医科大学,重庆400016 [2]中日友好医院,北京100029

出　　处：《心血管病学进展》2017年第5期488-492,共5页Advances in Cardiovascular Diseases

摘　　要：2型糖尿病血脂异常的特点为低密度脂蛋白胆固醇轻中度升高,高三酰甘油血症和高密度脂蛋白胆固醇降低,以及小而密低密度脂蛋白颗粒升高,且脂蛋白颗粒本身功能常常受损。对糖尿病患者动脉粥样硬化性心血管疾病的发生和发展起着重要促进作用,并导致残余风险增加。近年来大量临床研究肯定了他汀类药物在糖尿病患者动脉粥样硬化心血管疾病防治的基石地位。而传统的非他汀类的调脂药物,如烟酸和贝特类的证据不充分。新型非他汀调脂药物如胆固醇吸收抑制剂和前蛋白转化酶枯草杆菌蛋白酶9抑制剂在糖尿病患者均显示良好的疗效,是降低残余心血管病风险的有效手段;但需要关注调脂药物对糖代谢的不利影响。The main characteristics of dyslipidemia in type 2 diabetes（T2DM） are mild or moderate elevation of low-density lipopro- tein cholesterol, high triglyceride and low high-density lipoprotein cholesterol, with the presence of small and dense low＇density lipoprotein particle,and dysfunction of lipoprotein particles. The atherosclerogenic dyslipidemia plays an important role in the development and progress of cardiovascular diseases （CVD） in T2DM and increases the residual risk of CVD, Statins has been proven to be cornerstone treatment in the prevention of CVD in diabetic patients. The benefit of fibrate and niacin on top of statin has been challenging. The emerging new non-statin drugs, such as cholesterol absorption inhibitors and PCSK9 inhibitors could further reduce the residual risk of cardiovascular disease. However, there was increasing concern of the impact lipid lowering therapy on the glucose metabolism.

关 键 词：2型糖尿病 心血管疾病 调脂治疗 

分 类 号：R587.1[医药卫生—内分泌] R589.2[医药卫生—内科学]