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<title>そうだったんだ！脂質異常症 | 株式会社文光堂</title>


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<meta name="description" content="超高齢化社会を迎えたわが国において，末梢動脈硬化は冠動脈疾患とともに増加している．本書では，動脈硬化の主要な危険因子である脂質異常症について，患者の病態に合わせて効率よく心血管イベントを抑制する根拠を提示することを目的として，その治療の最新の潮流をまとめた．また，ガイドラインにとどまらず，最小限の薬剤投与の治療についての実例も症例検討形式で示している．エキスパートのオピニオンをふんだんに盛り込んだ">

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		<h1 class="title">そうだったんだ！脂質異常症<span class="version">第2版</span></h1>
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					編集：伊藤　浩（岡山大学大学院医歯薬学総合研究科循環器内科学教授）
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				<ul class="property"><li class="disc">B5判・272頁・4色刷</li><li class="disc">ISBN&nbsp;978-4-8306-1948-9</li><li class="disc">2020年3月5日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">超高齢化社会を迎えたわが国において，末梢動脈硬化は冠動脈疾患とともに増加している．本書では，動脈硬化の主要な危険因子である脂質異常症について，患者の病態に合わせて効率よく心血管イベントを抑制する根拠を提示することを目的として，その治療の最新の潮流をまとめた．また，ガイドラインにとどまらず，最小限の薬剤投与の治療についての実例も症例検討形式で示している．エキスパートのオピニオンをふんだんに盛り込んだ，臨床で役立つ一冊．</section><section class="preface">第2版 序文<br><br>　超高齢化社会を迎え，冠動脈疾患とともに末梢動脈硬化も増加している．スタチンは心血管イベントの予防に必須であり，今や二次予防患者ではベースラインのLDL-C値に関係なくスタチンを投与しできるだけLDL-Cを下げる，“the lower, the better”が確立されている．しかし，未解決の問題も多い．なぜLDL-Cの目標値がリスクによって異なるのか，なぜ2型糖尿病や慢性腎臓病ではLDL-Cが正常でもイベントリスクが高いのか，そしてスタチン治療でも残る70%余りの残余リスクに対してどのように対処すればよいのか，などである．スタチンは“one size fits all”型の治療であるが，今後注目されるのがPrecision medicine（精密医療）である．個々の患者において遺伝的背景，リスクそして動脈硬化の病態を正確に評価したうえで，最適な治療法を提案する必要がある．さらに，心血管イベントの予防にはどのように血管レベルの“炎症”を制御するか，そのような視点に立った治療法も求められている．また，ガイドライン通りに処方すると，薬剤数が異常に増えるケースが少なくない．特に高齢者ではポリピルが大きな問題であり，最小限の薬剤投与が求められている．<br>　このようなことを踏まえて脂質異常症治療の最新の潮流をまとめ，個々の患者の病態に合わせて効率よく心血管イベントを抑制する根拠を提示する目的で本書を企画した．さらに，（複数の）合併症を有する脂質異常症患者に対して最小限の薬剤でどのように治療できるか，という実例を症例検討で示した．ガイドラインを越えたエキスパートのオピニオンをふんだんに盛り込んだ本書を手に取っていただき，臨床に役に立ったと言っていただければ執筆者一同の大きな幸せである．<br><br>2020年2月吉日<br>岡山大学大学院医歯薬学総合研究科循環器内科学<br>伊藤　浩</section><section class="indexes">Ⅰ　脂質と脂質代謝<br>　1　脂肪酸とは<br>　2　PPARαの役割<br>　3　コレステロール代謝と役割<br>　4　リポ蛋白の代謝<br>　5　HDLの働きを理解する<br>　〔Topics〕腸内細菌叢と脂肪酸<br>　6　内臓脂肪と皮下脂肪<br><br>Ⅱ　脂質異常症の病態と診断<br>　1　リポ蛋白代謝の異常<br>　2　遺伝的脂質異常症<br>　3　LDLの目標値はなぜ病態で異なる？<br>　4　HDLの異常<br>　5　Lp（a）とその意義<br>　6　血液検査による評価<br><br>Ⅲ　必須不飽和脂肪酸に迫る<br>　1　EPA，DHAとアラキドン酸（AA）<br>　2　EPAとDHAの作用<br>　3　循環器疾患のエビデンス<br>　4　循環器疾患以外の疾患とのかかわり<br><br>Ⅳ　動脈硬化の機序と診断<br>　1　動脈硬化の機序<br>　2　動脈硬化のリスク因子<br>　3　動脈硬化の診断とリスク層別化<br>　〔Topics〕心外膜下脂肪と冠動脈硬化<br>　〔Topics〕不安定プラークを可視化する<br><br>Ⅴ　心不全と脂質代謝<br>　1　心不全と脂肪酸代謝<br>　2　糖尿病性心筋症<br><br>Ⅵ　脂質異常症の治療<br>　1　脂質異常症の治療ゴール<br>　2　食事療法のポイント<br>　3　LDL-Cを下げる<br>　4　中性脂肪を下げる<br>　5　糖尿病治療薬の選択<br>　6　治療効果を判定する<br>　〔Topics〕プラークを安定化させる<br><br>Ⅶ　合併疾患のある脂質異常症―治療をどうする？<br>　1　Diabetic dyslipidemia<br>　〔Controversy この症例をどう評価し，治療する？〕<br>　　C1　肥満，メタボリックシンドロームの脂質異常症<br>　〔Controversy この症例をどう評価し，治療する？〕<br>　　C2　2型糖尿病合併脂質異常症，一次予防<br>　2　Renal dyslipidemia<br>　〔Controversy この症例をどう評価し，治療する？〕<br>　　C3　CKD stage 3の脂質異常症<br>　3　家族性高コレステロール血症<br>　〔Controversy この症例をどう評価し，治療する？〕<br>　　C4　家族性高コレステロール血症ヘテロ接合体<br>　4　冠動脈疾患の二次予防<br>　〔Controversy この症例をどう評価し，治療する？〕<br>　　C5　2型糖尿病合併待機的PCI後1年<br>　〔Controversy この症例をどう評価し，治療する？〕<br>　　C6　急性冠症候群に対してPCI後退院時<br>　5　PADは二次予防と考えよう<br>　〔Controversy この症例をどう評価し，治療する？〕<br>　　C7　2型糖尿病を合併するPAD（フィブラートに下肢切断減少効果あり）<br>　6　高齢者の脂質異常症<br><br>Ⅷ　脂質異常症の新潮流<br>　1　Precision medicine<br>　2　Choosing wisely<br><br>索引</section></article>
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