高脂蛋白(a)血症和冠心病的关系及治疗进展  

Lipoprotein (a) and Coronary Artery Disease

作　　者：管宇 赵汉军[1] GUAN Yu;ZHAO Hanjun(Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Science & Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院心内科,北京100037

出　　处：《心血管病学进展》2019年第3期313-317,共5页Advances in Cardiovascular Diseases

基　　金：中国医学科学院医学与健康科技创新工程(2016-I2M-1-009)

摘　　要：脂蛋白(a)是脂蛋白的一种,可致动脉粥样硬化并影响纤维蛋白代谢,在冠心病一级预防和二级预防中占有重要位置。荟萃分析、孟德尔随机遗传研究和全基因组关联研究都显示脂蛋白(a)水平升高是冠心病的独立危险因素。此外,在低密度脂蛋白胆固醇控制达标的情况下,脂蛋白(a)水平升高仍然和冠心病不良预后相关。近年研究显示前蛋白转化酶枯草杆菌蛋白酶9抑制剂、反义寡核苷酸以及血脂净化均可降低脂蛋白(a)水平,部分药物可以改善冠心病的预后。然而,单独降低脂蛋白(a)水平的临床获益还不明确,需要进一步研究。Lipoprotein(a) is a type of lipoprotein that contributes to atherosclerosis and fibrin metabolism,which plays an important role in primary and secondary prevention of coronary heart disease.Meta-analysis,Mendelian randomization and Genome-Wide Association Studies indicate that elevated lipoprotein(a) level is an independent risk factor for coronary artery disease(CAD) and correlates with poor prognosis of CAD despite well controlled LDL-C concentration.The proprotein convertase subtilisin/kexin type 9 inhibitor,antisense therapy and lipid aphaeresis can reduce lipoprotein(a) levels,and some of them has been reported to improve the prognosis of CAD.However,the clinical benefit of reducing lipoprotein(a) levels alone is unclear and further investigation is expected.

关 键 词：脂蛋白(a) 冠心病 前蛋白转化酶枯草杆菌蛋白酶9抑制剂 反义寡核苷酸治疗 

分 类 号：R589.2[医药卫生—内分泌] R541.4[医药卫生—内科学]