糖尿病合并血脂代谢异常的药物治疗

2型糖尿病合并血脂代谢异常血脂谱的特点是血清三酰甘油(TG)及小而密低密度脂蛋白-胆固醇(sLDL-C)升高,高密度脂蛋白-胆固醇(HDL-C)降低。治疗措施包括生活方式干预、控制高血糖和调脂药物应用3个方面。治疗的首要目标是降低低密度脂蛋白-胆固醇(LDL-C),调脂药物首选他汀类,其他尚有依折麦布、血脂康、多廿烷醇、胆酸螯合剂及普罗布考等。单纯TG升高或TG明显升高(>4.52 mmol.L-1)患者,选择以降低TG为主的贝特类、烟酸类及其衍生物和Omega-3(ω-3)脂肪酸等药物。HDL-C低下患者除了生活方式干预外,可选择以烟酸类为主的调脂药物治疗。糖尿病合并混合型血脂异常患者的处理是在严格掌握适应症的情况下,选择以他汀类为主与其他调脂药物联合应用方案;非诺贝特对治疗该类血脂异常患者具有一定的优势。

Drug therapy for diabetes mellitus accompanied by dyslipidemia

The lipid profile of type 2 diabetes mellitus accompanied by dyslipidemia is characterized by increased serum triglyceride(TG),small dense LDL cholesterol(sLDL-C),and decreased high density lipoprotein cholesterol(HDL-C).Treatment of diabetes with dyslipidemia includes changes of life style,management of hyperglycemia and drug treatment of dyslipidemia.The primary target of therapy is to reduce LDL-C.Statins are considered as the first-line drugs to achieve LDL treatment goals,other drugs available are ezet...