阿托伐他汀与匹伐他汀调脂机制对比的研究进展

血脂异常尤其是胆固醇和/或三酰甘油(TG)水平的异常,已经成为促使动脉粥样硬化形成以及冠心病发生、发展的独立危险因素。我国血脂防治指南坚持将降低低密度脂蛋白胆固醇(LDL-C)水平作为预防动脉粥样硬化性心血管疾病(ASCVD)发生的首要干预靶点,将非高密度脂蛋白胆固醇(non-HDL-C)作为次要的干预靶点。目前,临床调脂达标的首选药物是他汀类药物,结构特点及代谢机制的不同使得他汀类药物具有差异性。本文将着重从化学结构、剂量、生物利用度、酶结合特性、组织穿透力和t1/2、代谢、消除、效力和调节胆固醇(主要是LDL-C)、TG及高密度脂蛋白胆固醇(HDL-C)机制等多个角度分析比较阿托伐他汀与匹伐他汀的异同点,为临床个体化用药提供理论依据。

Research Progress on the Comparison of Lipid Management Mechanism between Atorvastatin and Pitvastatin

Dyslipidemia，especially abnormal levels of cholesterol and/or triglycerides（TG），has become an independent risk factor of atherosclerosis and occurrence and development of coronary heart disease.Chinese guidelines for the prevention and treatment of blood lipid insist that lowering the level of low density lipoprotein cholesterol（LDL-C） is the primary intervention target for preventing atherosclerotic cardiovascular disease（ASCVD） and non-high density lipoprotei cholesterol（non-HDL-C） is the secondary intervention target.At present，the preferred drug for lipid regulation in clinical practice is statins，which may differ due to their different structural characteristics and metabolic mechanisms.This paper focused on the chemical structure，dosage，bioavailability，enzyme binding properties，tissue penetration and t1/2，metabolism，elimination，effectiveness and cholesterol regulation（mainly LDL-C），triglycerides and HDL-C mechanism to compare the similarities and differences between atorvastatin and pitavastatin，providing theoretical basis for clinical individualized medication.