脂蛋白a与冠状动脉粥样硬化疾病的研究进展  

Progress in lipoprotein(a)and coronary atherosclerosis

作　　者：刘宏[1] 黄杨 赵莉[1] 代巧妹[1] 杨婧[1] 张雨薇[1] 张梦迪 倪雪妍 仲丽丽[2] LIU Hong;HUANG Yang;ZHAO Li;DAI Qiaomei;YANG Jing;ZHANG Yuwei;ZHANG Mengdi;NI Xueyan;ZHONG Lili(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The First Affiliated Hospital,Heilongjiang Univer-sity of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学第一附属医院,黑龙江哈尔滨150040

出　　处：《中国病理生理杂志》2023年第4期730-738,共9页Chinese Journal of Pathophysiology

基　　金：国家自然科学基金面上项目(No.82074288);国家自然科学基金青年基金项目(No.81403288);中国博士后科学基金资助项目(No.2016M591565);黑龙江省青年科学基金项目(No.QC2015102);黑龙江省博士后资助项目(No.LBHZ15207);哈尔滨市科技局青年后备人才计划项目(No.2016RAQXJ202);黑龙江中医药大学研究生创新科研项目立项基金(No.2022yjscx012);黑龙江省自然科学基金联合引导项目(No.LH2022H068);黑龙江省卫生健康委科技计划(No.20220202080996)。

摘　　要：脂蛋白(lipoprotein)作为研究动脉粥样硬化疾病的常客,目前已得到广泛研究。而脂蛋白a[lipoprotein(a),Lp(a)]是一种密度介于高密度和低密度之间的特殊脂蛋白,与遗传因素息息相关。它富含载脂蛋白A(apolipoprotein A,apoA),可与胆固醇相结合,沉积于血管壁,促使动脉粥样硬化,形成血栓;它能促进血管炎症发生,影响斑块稳定性,是冠心病的独立风险因子。近年来随着对Lp(a)研究的深入,也出现了一批针对高Lp(a)疾病的降脂药物,科技和生物信息技术发展日新月异,对于Lp(a)的认识也在逐步提高。本文就Lp(a)结构、理化性质、与冠状动脉粥样硬化疾病之间的生物反应以及相关治疗药物的研究进展进行总结与阐述。Lipoprotein(a)[Lp(a)]is a kind of liver-derived lipoprotein,which consists of apolipoprotein(apo)B100 covalently bound to apoA.Therefore,it has atherothrombotic traits of both apoB(from low-density lipoprotein)and apoA(thrombo-inflammatory aspects).Recent advances in clinical and genetic research have revealed the crucial role of Lp(a)in the pathogenesis of cardiovascular diseases.High Lp(a)concentration has long been linked to increased risk of coronary atherosclerotic disease(CAD).Although conventional pharmacological therapies have failed to significantly reduce Lp(a)level,emerging new therapeutic strategies using proprotein convertase subtilisin-kexin type 9 inhibitors have shown promising results in effectively lowering Lp(a).This review summarizes the recent advances in the role of Lp(a)in the pathogenesis of CAD and the related lipid-lowering drugs.

关 键 词：脂蛋白A 冠状动脉粥样硬化 炎症 遗传 治疗药物 

分 类 号：R543.3[医药卫生—心血管疾病] R363.2[医药卫生—内科学]