斯達汀類藥物治療第二型糖尿病的高血脂及其安全性探討
 
蔡崇煌^1,2　李篤宜³　黃素雲⁴　張加憲¹　張惠雯¹

 
在三高之高血糖、高血壓及高血脂的治療中，高血脂症較易被病患及醫師忽視，但就心肌梗塞的風險而言，長期的高血脂症遠高於糖尿病及高血壓，特別是血漿中低密度脂蛋白膽固醇，更需追踪及治療。目前其治療目標為低一點比較好及越早治療越好，然斯達汀類藥物治療所造成過低的LDL-C，可能導致醫師及病患擔心其安全性或副作用，例如新生糖尿病或認知功能影響。本文舉一三高個案，以statins治療高血脂的過程，並回顧部份具有里程碑意義的降脂療法藥物試驗及其安全性或副作用，以提供國內醫療人員的參考。
（台灣家醫誌2019; 29: 1-11）DOI: 10.3966/168232812019032901001
 
關鍵詞：高血脂症、降脂療法、低密度脂蛋白膽固醇、心肌梗塞、新生糖尿病

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¹澄清醫院中港分院家庭醫學科、³心臟科；²東海大學運動休閒與健康管理進修學士班學位學程；⁴童綜合醫院家庭醫學科
受理日期：107年3月28日　　修改日期：107年5月3日　　同意刊登：107年6月19日

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Statins for Diabetic Hyperlipidemia and Their Safety
 
Chung-Huang Tsai^1,2, Du-Yi Lee³, Su-Yun Huang⁴, Chia-Hsien Chang¹and Hui-Wen Chang¹

Compared to hyperglycemia and hypertension, hyperlipidemia appears to receive less attention from both patients and physicians, yet long-term hyperlipidemia incurs much higher risk of myocardial infarction than hyperglycemia and hypertension. Among different lipid parameters, plasma low-density lipoprotein cholesterol (LDL-C) is in greater need to be tracked and treated. Treatment for LDL-C emphasizes “the lower, the better” and “the sooner, the better.” However, capable of producing a much lower LDL-C, statin treatment may cause physicians and patients to worry about its safety and side effects, such as new-onset diabetes or incident diabetes and cognitive dysfunction. The article showed how the process of applying statin therapy to treat hyperlipidemia in a diabetes case. Moreover, several landmark statins outcome trials of lipidlowering therapy (LLT) were also reviewed with a focus on examining their applications, safety, and side effects to provide a reference for medical professionals.
(Taiwan J Fam Med 2019; 29: 1-11) DOI: 10.3966/168232812019032901001
 
Key words:hyperlipidemia, lipid-lowering therapy, low-density lipoprotein cholesterol, myocardial infarction, new-onset diabetes

 

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¹Departments of Family Medicine, ³Cardiology, Chung-Kang Branch, Cheng Ching Hospital, Taichung; ²Tunghai University Sports Recreation and Health Management Continuing Studies - Bachelor's Degree Completion Program, Taichung; ⁴Department of Family Medicine, Tung's Taichung MetroHarbor Hospital, Taichung, Taiwan.
Received: March 28, 2018; Revised: May 3, 2018; Accepted: June 19, 2018.