代謝症候群中血脂異常的治療：實證醫學的證據

Evidence in the Treatment of Dyslipidemia in the Metabolic Syndrome

宋立勤(Li-Chin Sung) ； 王志鴻(Ji-Hung Wang)

《內科學誌》 19卷4期 (2008/08) Pp. 305-317

https://doi.org/10.6314/JIMT.2008.19(4).04

摘要

代謝症候群息者以心血管危險因子的組合爲特點並且與心血管的疾病和糖尿病的發生相關。其血脂異常的特點爲高三酸甘油酯、低的高密度脂蛋白膽固醇及小且緻密度高的低密度脂蛋白膽固醇。對於已有心血管疾病（如冠心病、腦中風、周邊動脈阻塞）或糖尿病患者，在2001年美國膽固醇教育計劃成人治療指引Ⅲ建議用statin類藥物來降低血中的低密度脂蛋白膽固醇，但是在代謝症候群或糖尿病患者仍有相對高的殘餘風險導致罹病和死亡。因爲肥胖及其相關疾病在世界上越來越多而逐漸重要，故積極的達到治療目標非常重要。這篇文章回顧代謝性症候群中的血脂異常，探討它的致病機轉及治療方針。

關鍵字

代謝症候群 ； 血脂異常 ； 實證醫學

並列摘要

The metabolic syndrome is a cluster of cardiovascular risk factors as characteristic and correlated with cardiovascular disease and the development of the diabetes mellitus. The characters of dyslipidemia are the hypertriglyceridemia, low high-density lipoprotein cholesterol and small dense low-density lipoprotein cholesterol. As to the patient having a cardiovascular disease (such as coronary artery disease, stroke, or peripheral artery occlusion) or the diabetes mellitus, the 2001 National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) Ⅲ suggests reducing the serum low-density lipoprotein cholesterol with statin. However, there remains a relatively high residual risk of morbidity or mortality in patients with the metabolic syndrome or diabetes mellitus, and this is of growing importance because of the increasing prevalence of obesity and its associated comorbidities in the world. The treatment to achieve aggressive goals is of paramount importance. This article reviews pathophysiology and emerging therapeutic strategies for the management of dyslipidemia in patients with the metabolic syndrome.

並列關鍵字

Metabolic Syndrome ； Dyslipidemia ； Evidence-based medicine