hdl药物治疗.pptVIP

Fenofibrate for Treatment of Types IV and V Hyperlipoproteinemia *Mean percentage changes, not percentage changes in means. Goldberg AC et al. Clin Ther 1989;11:69–83. 14.5 19.6 -46.2 45.0 22.9 -54.5 -60 -50 -40 -30 -20 -10 0 10 20 30 40 50 Group A (TG = 350–499 mg/dL) Group B (TG = 500–1,500 mg/dL) % change from baseline* LDL-C (128.4) HDL-C (33.7) LDL-C (103.1) HDL-C (29.6) Mean baseline (mg/dL): Total-TG (432.0) Total-TG (725.6) Trials of Agents That Increase HDL-C in Patients With Isolated Low HDL-CRandomized, Placebo-Controlled Studies 1. Vega GL, Grundy SM. JAMA 1989;262:3148–3153 2. Miller M et al. Am J Med 1993;94:7–12 3. Lavie CJ et al. Am J Cardiol 1992;69:1083–1085 4. King JM et al. Am J Med 1994;97:323–331 5. Miller M et al. Arterioscler Thromb Vasc Biol 1995;15:2151–2156 9 9 27 31 12 0 5 10 15 20 25 30 35 Vega (1) (n = 22) Miller (2) (n = 14) Lavie (3) (n = 19) King (4) (n = 15) Miller (5) (n = 39) Gemfibrozil Niacin Phenytoin % increase in HDL-C Trial: Drug Effects on HDL: Estrogens Liver B B TG CMR/IDL C-II CM/VLDL LPL A-I CE CE FC FC LCAT A-I ABC1 Macrophage Mature HDL Nascent HDL LDLR HL ESTROGENS + ESTROGENS Intestine Estrogen Versus Estrogen/Progestin in Postmenopausal WomenEffect on Lipids CEE = conjugated equine estrogen; MPA = medroxyprogesterone acetate; cyc = cyclic administration (days 1 through 12 of each month); con = administered daily for 1 month; MP = micronized progesterone Writing Group for PEPI Trial. JAMA 1995;273:199–208 -2.9 -2.0 -3.2 -10.3 9.0 13.9 -12.9 2.4 13.5 -11.6 1.9 11.1 -10.9 6.5 13.7 -20 -15 -10 -5 0 5 10 15 20 LDL-C HDL-C TG Placebo CEE CEE + MPA (cyc) CEE + MPA (con) CEE + MP (cyc) (143.3) (140.6) (137.0) (141.7) (135.7) % change from baseline (61.4) (61.9) (64.8) (62.7) (62.6) (99.0) (98.7) (94.3) (102.7) (97.5) Baseline (mg/dL): Statin Chemical Structures* O H CH3 CH3 H3C H3C O HO Simvastatin H3C H O O O H CH3 H H3C HO OH HO Pravastatin COONa H H H3C O O H CH3 H H3C H3C HO Lovastatin H H3C H N O*Na+ CH3 CH3 F