МЕСТО КОМБИНИРОВАННОЙ ГИПОЛИПИДЕМИЧЕСКОЙ ТЕРАПИИ (РОЗУВАСТАТИН/ЭЗЕТИМИБ) В ЛЕЧЕНИИ СЕРДЕЧНО- СОСУДИСТЫХ ЗАБОЛЕВАНИЙ, ВЫЗВАННЫХ АТЕРОСКЛЕРОЗОМ
DOI:
https://doi.org/10.54890/1694-8882-2025-1-45Аннотация
Сердечно-сосудистые заболевания ведущая причина смерти в мире. Причем смертность от них ежегодно увеличивается, и основная доля обусловлена атеросклеротической болезнью. Высокая распространенность болезней сердца в мире обусловлена наличием у пациентов ряда риск факторов. Помимо известных риск факторов, таких как повышенное артериальное давление, сахарный диабет, курение, гиподинамия, ожирение, важную роль в развитии заболеваний сердца играет и гиперлипидемия. Так лица с повышенным уровнем холестерина липопротеинов низкой плотности имеют в 2 раза выше риск развития атеросклеротической болезни, чем лица с нормальным его значением. Поэтому в качестве профилактических мероприятий в борьбе с данной патологией необходим контроль не только таких факторов, как избыточный вес, курение, алкоголь, гиподинамия, гипергликемия, повышенное давление, но и гиперхолестеринемии. В качестве препаратов, направленных на предотвращение развития атеросклеротической болезни и ее осложнений, статины являются наиболее изученными препаратами, применяемых при первичной и вторичной профилактике. Однако при применении статинов только примерно 1/3 пациентов достигает целевого уровня холестерина. Кроме того, иногда могут развиться (хотя и очень редко) и побочные эффекты, включая миопатию и рабдомиолиз, новые случаи диабета. Для увеличения частоты достижения целевого уровня ЛПНП-ХС и уменьшения риска развития побочных эффектов, рекомендуется применение комбинации гиполипидемических препаратов с синергичным механизмом действия, причем назначения их в 1-й таблетке. Такой комбинацией является статин + эзетимиб, препарат, препятствующий обратному всасыванию холестерина в кишечнике. В качестве статина рекомендуется росувастатин, обладающий наибольшим гиполипидемическим действием. Комбинация росувастатин+эзетимиб показала преимущество перед монотерапией статином в плане снижения холестерина липопротеинов низкой плотности и уменьшения развития побочных эффектов.
Ключевые слова:
атеросклеротическая болезнь, холестерин, холестерин липопротеинов низкой плотности, гиперхолестеринемия, статин, эзетимибБиблиографические ссылки
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