第27章 调血脂药与抗动脉粥样硬化药gu.ppt

第三节 多烯脂肪酸 一、n-3型多烯脂肪酸 二十碳五烯酸（eicosapentaenoic acid, EPA） 二十二碳六烯酸（docosahexaenoic acid, DHA） 【药理作用与机制】 调血脂作用 非调血脂作用 【临床应用】 适用于高TG性高脂血症； 对心肌 梗死患者的预后有明显改善； 亦可用于糖尿病并发高脂血症等。 第三节 多烯脂肪酸 二、n-6型多烯脂肪酸 主要来源于植物油，有亚油酸（linoleic acid,LA ) 和γ-亚麻酸（γ-linolenic acid,γ-LNA）。 常用月见草油（evening primrose oil）和亚油酸（linoleic acid）。 用于防治冠心病及心肌梗死等，但作用较弱。 第四节 黏多糖和多糖类 低分子量肝素与天然类肝素， 主要用于临床用于缺血性心脑血管疾病。 * Figure The major pathways involved in the metabolism of chylomicrons synthesized by the intestine and VLDL synthesized by the liver. Chylomicrons are converted to chylomicron remnants by the hydrolysis of their triglycerides by LPL. Chylomicron remnants are rapidly cleared from the plasma by the liver. Remnant receptors include the LDL receptor-related protein (LRP), LDL, and perhaps other receptors. FFA released by LPL is used by muscle tissue as an energy source or taken up and stored by adipose tissue. FFA, free fatty acid; HL, hepatic lipase; IDL, intermediate-density lipoproteins; LDL, low-density lipoproteins; LPL, lipoprotein lipase; VLDL, very-low-density lipoproteins.  * Figure Metabolism of lipoproteins of hepatic origin. The heavy arrows show the primary pathways. Nascent VLDL are secreted via the Golgi apparatus. They acquire additional C lipoproteins and apo E from HDL. VLDL are converted to VLDL remnants (IDL) by lipolysis via lipoprotein lipase in the vessels of peripheral tissues. In the process, C apolipoproteins and a portion of the apo E are given back to HDL. Some of the VLDL remnants are converted to LDL by further loss of triglycerides and loss of apo E. A major pathway for LDL degradation involves the endocytosis of LDL by LDL receptors in the liver and the peripheral tissues, for which apo B-100 is the ligand. (Dark color denotes cholesteryl esters; light color, triglycerides; the asterisk denotes a functional ligand for LDL receptors; triangles indicate apolipoprotein E; circles and squares represent C apolipoproteins; R