脂蛋白a在心血管疾病中的研究新进展  

Latest Progress of Lipoprotein(a)in Cardiovascular Diseases

作　　者：李婕 丁虎 LI Jie;DING Hu(Department of Cardiovascular Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院心血管内科,湖北省武汉市430030

出　　处：《中国全科医学》2024年第36期4505-4514,4521,共11页Chinese General Practice

基　　金：“十四五”国家重点研发计划项目(2021YFC2500604)。

摘　　要：脂蛋白a[Lp(a)]升高与动脉粥样硬化性心血管疾病(ASCVD)显著相关,但降低Lp(a)的临床药物能否降低ASCVD发生风险尚不明确。本文系统综述了Lp(a)的结构、功能、遗传学特性以及检测现状,探讨了Lp(a)与ASCVD、主动脉瓣狭窄以及其他心血管疾病之间的关联性,并总结了降Lp(a)的治疗新进展。Lp(a)的结构组成表明,Lp(a)可能具有促进动脉粥样硬化、抑制纤溶反应和促进炎症的作用。遗传学和流行病学研究的多种证据支持,Lp(a)与ASCVD以及主要不良心血管事件风险增加显著相关。此外,Lp(a)还与主动脉瓣狭窄等其他心血管疾病相关。目前,一些新兴的降Lp(a)药物正在临床试验阶段,可能进一步降低心血管残余风险。本文希望能够为Lp(a)的研究提供新思路,并为血脂监测与管理提供依据。Lipoprotein(a)[Lp(a)]is significantly related to atherosclerotic cardiovascular disease(ASCVD),but it is unclear whether clinical agents that lower Lp(a)can reduce the risk of ASCVD.Here,we systematically reviewed the structure,function,genetic characteristics and detection status of Lp(a),discussed the relationship of Lp(a)with ASCVD,aortic valve stenosis and other cardiovascular diseases,and summarized new advance of Lp(a)-lowering therapies.The structural composition of Lp(a)indicates that Lp(a)may promote atherosclerosis,inhibit fibrinolytic reaction and promote inflammation.Multiple evidence from genetic studies and epidemiological studies supports that Lp(a)is significantly associated with an increased risk of ASCVD and major adverse cardiovascular events.In addition,Lp(a)is also associated with other cardiovascular diseases such as aortic valve stenosis.At present,several emerging drugs that lower Lp(a)are in clinical trials and may further reduce residual cardiovascular risk.This paper hopes to offer new thought for the study of Lp(a),and provide a basis for the monitoring and management of blood lipids.

关 键 词：心血管疾病 动脉粥样硬化 脂蛋白A 遗传学 主要不良心血管事件 降脂蛋白a药物 

分 类 号：R54[医药卫生—心血管疾病]