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他汀类药物降低LDL-C可以显著减少心血管事件,但2型糖尿病患者经过他汀类药物治疗后仍面临很高的心血管剩留风险。高TG和低HDL-C是2型糖尿病主要异常血脂表型。高TG导致LDL颗粒改变,形成的小而密LDL颗粒(LDL-P),易于致动脉粥样硬化。LDL-P较LDL-C预测未来心血管事件更加敏感,LDL-P和载脂蛋白B(ApoB)较LDL-C与代谢综合征的危险程度相关性更显著。非诺贝特可以显著降低代谢综合征患者LDL-P浓度。对于糖尿病和代谢综合征人群,在应用他汀类药物治疗后,尚存在高TG、低HDL-C和高ApoB(LDL-P)异常血脂谱的患者,联用非诺贝特类药物降低血管剩留风险,应当是他汀类药物治疗后的调脂治疗策略。
Statins lowering LDL-C can significantly reduce cardiovascular events, but patients with type 2 diabetes still face high cardiovascular risk after statin therapy. High TG and low HDL-C are the major dyslipidemic phenotypes of type 2 diabetes. High TG lead to LDL particles change, the formation of small, dense LDL particles (LDL-P), easy to cause atherosclerosis. LDL-P is more sensitive to predict future cardiovascular events than LDL-C, LDL-P and apolipoprotein B (ApoB) are more significant than the risk of LDL-C and metabolic syndrome. Fenofibrate can significantly reduce LDL-P concentrations in patients with metabolic syndrome. For people with diabetes and metabolic syndrome, patients with abnormally high TG, low HDL-C, and high ApoB (LDL-P) dyslipidemia after statin therapy are treated with fenofibrate Stay risk, should be statin treatment of lipid-lowering treatment strategy.