中国药物警戒 ›› 2026, Vol. 23 ›› Issue (2): 235-240.
DOI: 10.19803/j.1672-8629.20250788

• 综述 • 上一篇    

降脂药物研究进展

王丽1, 邬静2, 李敏1, 袁嘉欣1, 于文雯1#, 戚迎梅1,*   

  1. 1济南市药品不良反应和医疗器械不良事件监测中心，山东 济南 250013;
    2菏泽市巨野县市场监督管理局，山东 菏泽 274900
  • 收稿日期:2025-11-10 出版日期:2026-02-15 发布日期:2026-02-13
  • 通讯作者: *戚迎梅，女，硕士，主任药师，药品不良反应监测。E-mail: 781164184@qq.com; #为共同通信作者。
  • 作者简介:王丽，女，硕士，副主任药师，药品不良反应监测。

Research Progress in Lipid-Lowering Drugs

WANG Li1, WU Jing2, LI Min1, YUAN Jiaxin1, YU Wenwen1#, QI Yingmei1,*   

  1. 1Jinan Adverse Drug Reaction and Medical Device Adverse Event Monitoring Center, Jinan Shandong 250013, China;
    2Juye County Market Regulatory Administration, Heze Shandong 274900, China
  • Received:2025-11-10 Online:2026-02-15 Published:2026-02-13

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摘要： 目的 探究降脂药物研究进展，为制定临床调脂方案和合理用药提供参考。方法 检索中国知网、PubMed、Web of Science等，检索时限为各数据库自建库至2025年12月31日，根据作用机制将降脂药物分为经典类（他汀类、胆固醇吸收抑制剂、贝特类、烟酸类、胆汁酸螯合剂、多不饱和脂肪酸类）与新型类[前蛋白转化酶枯草溶菌素9（PCSK9）抑制剂、血管生成素样蛋白3（ANGPTL3）抑制剂、载脂蛋白C3（ApoC3）抑制剂、载脂蛋白B（ApoB）合成抑制剂、微粒体TG转移蛋白（MTP）抑制剂、ATP柠檬酸裂合酶（ACLY）抑制剂]，汇总其作用机制、适应证、典型的药品不良反应（Adverse Drug Reactions, ADR）及用药监护等信息。结果 经典降脂药物以抑制胆固醇合成或吸收为主要机制，是血脂管理的基础，但其肌损伤、肝损伤等风险需密切监测;新型降脂药物多针对特定靶点，具有作用强、给药便捷等特点，安全性总体良好，常见ADR为注射部位反应等。结论 降脂药物已从广谱调控向精准靶向发展，临床应个体化选药，并重视对各类药物典型ADR的监测与防范，保障精准安全用药。

关键词: 血脂异常, 经典降脂药物, 新型降脂药物, PCSK9抑制剂, ANGPTL3抑制剂, ApoC3抑制剂, ApoB合成抑制剂, MTP抑制剂, ACLY抑制剂, 药品不良反应

Abstract: Objective To investigate the research progress in lipid-lowering drugs so as to provide new insights for developing clinical lipid management strategies and promoting rational drug use. Methods Such databases as CNKI, PubMed, and Web of Science were searched for literature published between the inception of each database and December 31, 2025. Based on their mechanisms of action, lipid-lowering drugs were categorized into classic agents (statins, cholesterol absorption inhibitors, fibrates, niacin, bile acid sequestrants, and polyunsaturated fatty acids) and novel agents (proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors, angiopoietin like protein 3 (ANGPTL3) inhibitors, apolipoprotein C3 (ApoC3) inhibitors, apolipoprotein B (ApoB) synthesis inhibitors, microsomal triglyceride transfer protein (MTP) inhibitors, and ATP citrate lyase (ACLY) inhibitors. Their mechanisms of action, indications, adverse drug reactions (ADR), and information on medication monitoring were summarized. Results Classic lipid-lowering drugs, primarily working by inhibiting cholesterol synthesis or absorption, underlay lipid management. However, their risks, such as myotoxicity and hepatotoxicity, required rigorous monitoring. Novel lipid-lowering drugs mostly targeted specific pathways and characterized by potent efficacy and easy administration. Their safety profiles were generally favorable, with such common ADR as injection site reactions. Conclusion Lipid-lowering drugs have evolved from broad-spectrum regulation to precise targeting. Drug selection in clinical practice should be individualized, with emphasis on monitoring and preventing typical ADR associated with different drug classes in order to ensure precise and safe medication.

Key words: Dyslipidemias, Classical Lipid-lowering Drugs, Novel Lipid-lowering Drugs, PCSK9 Inhibitors, ANGPTL3 Inhibitors, ApoC3 Inhibitors, ApoB Synthesis Inhibitors, MTP Inhibitors, ACLY Inhibitors, Adverse Drug Reactions

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