Получена: 9 ноябя 2023/ Принята: 24 ноября 2023/ Опубликована online: 28 декабря 2023
УДК 616-089-07
DOI: 10.26212/2227-1937.2023.75.44.003
А. Г. Ракишева1 ORCID: https://orcid.org/0000-0001-9842-962X
Д. Т. Сенкибаева2 ORCID: https://orcid.org/0009-0009-6245-8336
С. Б. Ердесов4, 5 ORCID: https://orcid.org/0000-0002-6377-7744
М. Ш. Абдильдаев2 ORCID: https://orcid.org/0000-0003-2436-9454
М. А. Нуржанова2, 3, ORCID: https://orcid.org/0000-0003-2561-8707
1 Городская больница г. Конаев, Казахстан
2 Научно-Исследовательский Институт Кардиологии и Внутренних Болезней
3Казахстанский Медицинский Университет “Высшая школа общественного здравоохранения”, г.Алматы, Казахстан
4 Школа Медицины, Назарбаев Университет, Астана, Казахстан
5 РГП на ПХВ «Национальный центр общественного здравоохранения» МЗ РК, Астана, Казахстан
РОЛЬ ДИСЛИПИДЕМИИ У ПАЦИЕНТОВ ПОСЛЕ АОРТО-КОРОНАРНОГО ШУНТИРОВАНИЯ
Резюме: Дислипидемии – нарушения в системе транспорта липидов и липопротеинов, проявляющееся
повышенными показателями холестерина (ХС), триглицеридов (ТГ), липопротеина низкой плотности (ЛПНП) и
обратным снижением уровней липопротеинов высокой плотности (ЛПВП), которое наиболее часто ассоциируется с
повышенным риском атеросклеротических сердечно-сосудистых заболеваний (АССЗ). Мировые данные 2019 года
по смертности вследствие ишемической болезни сердца показывают, что из 8.54 миллионов смертей, около
половины связано с повышенным уровнем ЛПНП.
В настоящее время дислипидемии являются активной и расширяющейся областью исследований, включая
исследования относительно их молекулярной основы и генетического происхождении.
Однако дислипидемии у пациентов после реваскуляризации миокарда имеют свои особенности в
предоперационном и послеоперационном периоде. Контроль за уровнем ХС ЛПНП у пациентов до АКШ, включает в
себя прием высоких доз статинов до проведения операции, так как это значительно снижает риск сердечно
сосудистых событий (на 44%) в виде смерти и инфаркта миокарда. После АКШ уровень ХС ЛПНП имеет прямую
зависимость с рисками серьезных сердечно-сосудистых событий (MACE).
Данный обзор на основе актуальных литературных данных позволит суммировать уже имеющиеся данные и
осветить усовершенствования, включая классификацию дислипидемий и их роль в развитии атеросклероза
коронарных артерий (КА), а также методы лечения атеросклероза КА, хирургические и медикаментозные, включая
новейшие методы лечения.
Ключевые слова: дислипидемия, атеросклероз коронарных артерий, гиполипидемическая терапия,
аортокоронарное шунтирование, ингибиторы PCSK9.
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