Ruf J C
Nutrition and Health Unit, International Wine and Vine Office, Paris, France.
Drugs Exp Clin Res. 1999;25(2-3):125-31.
Epidemiological studies have demonstrated an inverse correlation between moderate wine and alcohol consumption and morbidity and mortality from coronary heart disease (CHD). This protective effect has been associated with an increase in the plasma level of high density lipoprotein (HDL)-cholesterol, as it is well known that plasma HDL is inversely correlated with CHD. In addition, it has become evident that blood platelets contribute to the rate of development of atherosclerosis and CHD through several mechanisms. Recent studies have shown HDL-cholesterol levels can explain only 50% of the protective effect of alcoholic beverages. The other 50% may be partly related to decreased platelet activity. The antiplatelet activity of wine is explained not only by ethanol but also by the polyphenolic components with which red wines are richly endowed. Several studies carried out in humans and animals have shown that wine phenolics could exert their effects by reducing prostanoid synthesis from arachidonate. In addition, it has been suggested that wine phenolics could reduce platelet activity mediated by nitric oxide. Moreover, wine phenolics increase vitamin E levels while decreasing the oxidation of platelets submitted to oxidative stress. However, a rebound phenomenon of hyperaggregability is observed after acute alcohol consumption but not after wine consumption. This protection afforded by wine has been duplicated in animals with grape phenolics added to alcohol. This rebound phenomenon could explain ischemic strokes or sudden deaths known to occur after episodes of drunkenness. It appears that wine and wine phenolics in particular could significantly inhibit platelet aggregation and that this could explain, at least in part, the protective effect of red wine against atherosclerosis and coronary heart disease.
流行病学研究表明，适量饮用葡萄酒和酒精与冠心病（CHD）的发病率和死亡率之间存在负相关。这种保护作用与血浆高密度脂蛋白（HDL）胆固醇水平的升高有关，因为众所周知，血浆HDL与CHD呈负相关。此外，很明显血小板通过多种机制促进动脉粥样硬化和CHD的发展。最近的研究表明，HDL胆固醇水平只能解释酒精饮料保护作用的50%。另外50%可能部分与血小板活性降低有关。葡萄酒的抗血小板活性不仅由乙醇解释，还由红葡萄酒中丰富的多酚成分解释。在人和动物身上进行的几项研究表明，葡萄酒中的酚类物质可以通过减少花生四烯酸合成前列腺素发挥作用。此外，有人认为葡萄酒中的酚类物质可以降低一氧化氮介导的血小板活性。此外，葡萄酒中的酚类物质可提高维生素E水平，同时减少遭受氧化应激的血小板的氧化。然而，急性饮酒后会出现血小板高聚集性的反弹现象，而饮用葡萄酒后则不会。在给动物饮用添加了葡萄酚类物质的酒精后，葡萄酒的这种保护作用得到了重现。这种反弹现象可以解释醉酒后已知会发生的缺血性中风或猝死。看来葡萄酒，尤其是葡萄酒中的酚类物质，可以显著抑制血小板聚集，这至少可以部分解释红酒对动脉粥样硬化和冠心病的保护作用。
