抗脂血剤療法

Abstract

The main antilipemic agents now in use and at the stage of clinical trial are hereunder enumerated by action. Most of the following drugs are in use selectively according to the type of hyperlipemia:1. Preventing the absorption of cholesterol β-Sitosterol, Nicomol (Cholexamin), Linoleamides, Cholestane-triol, Alisol A monoacetate etc.2. Preventing the absorption of bile acid Cholestyramine, Colestipol, Neomycin, Dimethylaminoethyl Sephadex etc.3. Inhibiting the biosynthesis of cholesterol Clofibrate (CPIB, Amotrol), Simfibrate (Cholesolvin), S-8527 (Lipoclin), Halofenate (MK-185), Tibric acid, Nicotinic acid etc. Anabolic Steroidsi. 2-Hydroxymethylene-17α-methyl-dihydrotestosterone (HMD, Anadrol)ii. 17β-Hydroxy-17α-methyl-5α-androstano [2, 3-C] furazan (Miotron)iii. 17β-Hydroxy-17α-methyl-2-oxa-androstan-3-one (Oxandrolone, Vasorome)iv. 17α-Ethyl-17β-hydroxy-estr-4-ene (Ethylnandrol, Orgabolin)4. Accelerating the catabolism of cholesterol Thyroid hormone (D-thyroxine), Acetiromate (TBF-43), Estrogen, Unsaturated fatty acids, EPL (Essential phospholipid), Cholagoga etc.5. Influencing the transport and/or distribution of lipids Heparin and heparinoids, Dextran sulfate, Elastase etc.6. Reducing the lipoperoxide in the serum Riboflavin tetrabutyrate, dl-α-Tocopheryl nicotinate etc.It is ascertained by epidemiological survey and experimental studies that there is a correlation between hyperlipemia and atherosclerosis. It is also certain that to reduce the serum lipids is an effective measure to prevent the onset or progress of atherosclerosis. Many antilipemic agents have been developed by these principles. The papers, reporting the effectiveness of antilipemic agents for primary or secondary prevention of coronary atherosclerosis, support these principles.However, as was recently reported by the Coronary Drug Project of the USA, such papers became occasionally seen as reporting that the treatment by these natilipemic agents is not always effective to prevent the progress of atherosclerosis. It must be said therefore that these reports gave an opportunity for severe reconsideration on the treatment of atherosclerosis with antilipemic agents.Although the relation of hyperlipemia and atherosclerosis is ascertained as mentioned previously, there are some problems to expect the therapeutic effect by the treatment only with antilipemic agents, since the atherosclerosis is considered to be a multifactorial disease.The treatment with antilipemic agents can hardly be considered at the present stage to be of no use as a therapy for atherosclerosis since the relation of hyperlipemia and atherosclerosis is already confirmed as mentioned and to reduce the serum lipids is currently authenticated as an effective measure to prevent the progress of atherosclerosis. It must be however pointed out that the development and the use of antilipemic agents require circumspection.