Wierzbicki A S
Curr Med Res Opin. 2001;17(1):74-7.
Extensive trial evidence supports the use of hydroxy-methyl-glutaryl-CoA reductase inhibitors (HMG-CoA-RI; statins) in atherosclerotic disease. Statins can be divided into two broad groups: the 'natural' statins derived from a fungal metabolites, and synthetic compounds. Whether all statins have similar anti-atherosclerotic properties, or whether these actions are specific to the 'natural' statins, is controversial. This commentary reviews the differences between natural and synthetic statins with regard to lipid-lowering and non-lipid-lowering effects, including their action on the acute phase reactant C-reactive protein. Among the newer synthetic statins, fluvastatin has some positive end-point evidence while cerivastatin shares many biochemical properties with the 'natural' statins. Extensive clinical trial programmes are underway with both atorvastatin and cerivastatin. These trials will give a definitive answer to the question of whether synthetic statins are as equally efficacious as 'natural' statins in preventing atherosclerotic events.
大量试验证据支持在动脉粥样硬化疾病中使用羟甲基戊二酰辅酶A还原酶抑制剂（HMG-CoA-RI；他汀类药物）。他汀类药物可分为两大类：源自真菌代谢产物的“天然”他汀类药物和合成化合物。所有他汀类药物是否具有相似的抗动脉粥样硬化特性，或者这些作用是否特定于“天然”他汀类药物，存在争议。本评论综述了天然他汀类药物和合成他汀类药物在降脂和非降脂作用方面的差异，包括它们对急性期反应物C反应蛋白的作用。在较新的合成他汀类药物中，氟伐他汀有一些阳性终点证据，而西立伐他汀与“天然”他汀类药物具有许多生化特性。阿托伐他汀和西立伐他汀都在进行广泛的临床试验项目。这些试验将对合成他汀类药物在预防动脉粥样硬化事件方面是否与“天然”他汀类药物同样有效的问题给出明确答案。
