血脂异常-已知的未知。

Q4 Medicine
Martin Šatný
{"title":"血脂异常-已知的未知。","authors":"Martin Šatný","doi":"10.36290/vnl.2023.060","DOIUrl":null,"url":null,"abstract":"<p><p>Dyslipidemia (DLP) is the most important risk factor for atherosclerotic cardiovascular disease (ASCVD) and, in the context of severe hypertriglyceridemia (TG &gt; 10 mmol/l), a risk factor for the development of acute pancreatitis. The prevalence of DLP is very high, but their control, especially among the patients at highest risk, is often inadequate. When diagnosing DLP, we should always exclude its possible secondary aetiology (e.g. DLP in the context of hypothyroidism, diabetes, ...). Based on the assessment of the overall CV risk (according to SCORE2/SCORE2-OP or according to the comorbidities of the individual), target values for blood lipids, especially LDL-cholesterol, are determined according to the risk category. The basis of the management of DLP in the prevention of ASCVD is dietary and regimen measures, followed by adequate lipid-lowering therapy in indicated cases. As of April 2023, the portfolio of lipid-lowering medication has been expanded to include inclisiran (small interfering RNA against proprotein convertase subtilisin/kexin type 9 (PCSK9)), which is administered directly in cardiologists' and internists' outpatient clinics, ensuring 100% adherence. In severe hypertriglyceridaemia, fibrate monotherapy may be indicated in addition to dietary and regimen measures; if this treatment fails, some patients may be offered lomitapide, volanesorsen or evinacumab as part of clinical trials or specific treatment programmes if very strict indication criteria are met.</p>","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Dyslipidemia - the known unknown.\",\"authors\":\"Martin Šatný\",\"doi\":\"10.36290/vnl.2023.060\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Dyslipidemia (DLP) is the most important risk factor for atherosclerotic cardiovascular disease (ASCVD) and, in the context of severe hypertriglyceridemia (TG &gt; 10 mmol/l), a risk factor for the development of acute pancreatitis. The prevalence of DLP is very high, but their control, especially among the patients at highest risk, is often inadequate. When diagnosing DLP, we should always exclude its possible secondary aetiology (e.g. DLP in the context of hypothyroidism, diabetes, ...). Based on the assessment of the overall CV risk (according to SCORE2/SCORE2-OP or according to the comorbidities of the individual), target values for blood lipids, especially LDL-cholesterol, are determined according to the risk category. The basis of the management of DLP in the prevention of ASCVD is dietary and regimen measures, followed by adequate lipid-lowering therapy in indicated cases. As of April 2023, the portfolio of lipid-lowering medication has been expanded to include inclisiran (small interfering RNA against proprotein convertase subtilisin/kexin type 9 (PCSK9)), which is administered directly in cardiologists' and internists' outpatient clinics, ensuring 100% adherence. In severe hypertriglyceridaemia, fibrate monotherapy may be indicated in addition to dietary and regimen measures; if this treatment fails, some patients may be offered lomitapide, volanesorsen or evinacumab as part of clinical trials or specific treatment programmes if very strict indication criteria are met.</p>\",\"PeriodicalId\":23501,\"journal\":{\"name\":\"Vnitrni lekarstvi\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vnitrni lekarstvi\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.36290/vnl.2023.060\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vnitrni lekarstvi","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36290/vnl.2023.060","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

摘要

血脂异常(DLP)是动脉粥样硬化性心血管疾病(ASCVD)最重要的危险因素,在严重高甘油三酯血症(TG>;10mmol/l)的情况下,也是发展为急性胰腺炎的危险因素。DLP的患病率非常高,但他们的控制,尤其是在高危患者中,往往不够充分。在诊断DLP时,我们应该始终排除其可能的次要病因(例如甲状腺功能减退、糖尿病等情况下的DLP)。基于对总体CV风险的评估(根据SCORE2/SCORE2-OP或根据个体的合并症),根据风险类别确定血脂的目标值,尤其是LDL胆固醇。DLP预防ASCVD的基础是饮食和方案措施,然后在适应症病例中进行适当的降脂治疗。截至2023年4月,降脂药物组合已扩大到包括inclisiran(针对前蛋白转化酶枯草杆菌蛋白酶/kexin 9型(PCSK9)的小干扰RNA),该药物在心脏病专家和内科医生的门诊直接给药,确保100%的依从性。在严重的高甘油三酯血症中,除了饮食和方案措施外,可能还需要单用贝特治疗;如果这种治疗失败,如果符合非常严格的适应症标准,一些患者可能会作为临床试验或特定治疗方案的一部分接受洛米他吡、沃兰索森或埃伐单抗治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dyslipidemia - the known unknown.

Dyslipidemia (DLP) is the most important risk factor for atherosclerotic cardiovascular disease (ASCVD) and, in the context of severe hypertriglyceridemia (TG > 10 mmol/l), a risk factor for the development of acute pancreatitis. The prevalence of DLP is very high, but their control, especially among the patients at highest risk, is often inadequate. When diagnosing DLP, we should always exclude its possible secondary aetiology (e.g. DLP in the context of hypothyroidism, diabetes, ...). Based on the assessment of the overall CV risk (according to SCORE2/SCORE2-OP or according to the comorbidities of the individual), target values for blood lipids, especially LDL-cholesterol, are determined according to the risk category. The basis of the management of DLP in the prevention of ASCVD is dietary and regimen measures, followed by adequate lipid-lowering therapy in indicated cases. As of April 2023, the portfolio of lipid-lowering medication has been expanded to include inclisiran (small interfering RNA against proprotein convertase subtilisin/kexin type 9 (PCSK9)), which is administered directly in cardiologists' and internists' outpatient clinics, ensuring 100% adherence. In severe hypertriglyceridaemia, fibrate monotherapy may be indicated in addition to dietary and regimen measures; if this treatment fails, some patients may be offered lomitapide, volanesorsen or evinacumab as part of clinical trials or specific treatment programmes if very strict indication criteria are met.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Vnitrni lekarstvi
Vnitrni lekarstvi Medicine-Internal Medicine
CiteScore
0.50
自引率
0.00%
发文量
104
期刊介绍: Vnitřní lékařství je tiskovým orgánem České internistické společnosti České lékařské společnosti Jana Evangelisty Purkyně a Slovenskej internistickej spoločnosti Slovenskej lekárskej spoločnosti. Je vydáván nepřetržitě od roku 1955. Časopis vychází jako měsíčník, tedy 12krát do roka a podle potřeby jsou v běžném ročníku vydávána jeho suplementa, která jsou obsahově zaměřena k určitému tématu. Tematicky je časopis zaměřen široce na oblast interní medicíny se zvláštní pozorností ke kardiologii, diabetologii a poruchám metabolizmu.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信