中国实用内科杂志2026，Vol.46Issue(8)：659-667,9.DOI:10.19538/j.nk2026080107
调脂药物研究现状及研发前景
Research status and development prospects in lipid-lowering agents
摘要
Abstract
Dyslipidemia is a core driver for atherosclerotic cardiovascular disease(ASCVD),participating in the development of metabolic dysfunction-associated steatohepatitis(MASH),type 2 diabetes mellitus,obesity,and related malignancies through multiple mechanisms,including lipotoxicity,inflammatory activation and immunometabolic remodeling.According to the 2024 China Cardiovascular Health and Disease Report,the prevalence of dyslipidemia among adults in China is as high as 38.1％,contributing to a sustained increase in the burden of ASCVD.Although statins significantly reduce the risk of ASCVD events,the problems of residual cardiovascular risk and intolerance remain.In recent years,rapid advances have been made in monoclonal antibodies,antisense oligonucleotides,and RNA interference technologies targeting key molecules such as PCSK9,ANGPTL3,apo C3,and Lp(a),which brings new breakthroughs in the development of lipid-modifying agents.Beyond cardiovascular disease,targeting lipid metabolism has emerged as a promising therapeutic strategy for MASH and cancer.The THRβ,GLP-1R have emerged as important novel targets for the treatment of MASH and related disease.Collectively,lipid-modifying therapy is undergoing a paradigm shift from simply lowering LDL-C to achieving systemic metabolic improvement.This review systematically outlines the current state of application and development of lipid-modifying drugs based on the mechanistic basis and clinical evidence,and offers perspectives on future directions of drug development from a preclinical viewpoint.关键词
血脂异常/动脉粥样硬化/脂代谢/系统性代谢重塑Key words
dyslipidemia/atherosclerosis/lipid metabolism/systemic metabolic remodeling分类
医药卫生引用本文复制引用
史鸿路,谢治富,李静雅..调脂药物研究现状及研发前景[J].中国实用内科杂志,2026,46(8):659-667,9.基金项目
国家科技重大专项(2024ZD0523100) （2024ZD0523100）
国家自然科学基金(82425058) （82425058）
