Urbauer Eleonora, Joukhadar Christian
Universitätsklinik für Klinische Pharmakologie, Universitätsklinik für Innere Medizin I, Wien.
Wien Med Wochenschr. 2003;153(11-12):244-9. doi: 10.1046/j.1563-258x.2003.03028.x.
Hydroxy-methylglutaryl coenzyme A reductase-inhibitors (HMG-CoA [statins]) are currently the most effective method to pharmacologically decrease total plasma cholesterol levels. A number of multicenter studies have demonstrated, that statins administered for several years lead to a significant reduction of cardiovascular events and mortality compared with placebo. Apart from the well known LDL- and cholesterol lowering effect, statins have been postulated to exert beneficial effects on mortality due to so called 'non-lipid effects'. There is circumstantial evidence from a number of experimental studies that statins can improve endothelial function, exert anti-inflammatory and anti-oxidative effects, stabilize arteriosclerotic plaque and inhibit proliferation and activation of smooth muscle cells. However, the clinical implications of these beneficial 'non-lipid effects' are unclear, but appear to exert only a minor role in comparison to the lowering effect of statins on total plasma cholesterol levels.
羟甲基戊二酰辅酶A还原酶抑制剂（HMG-CoA [他汀类药物]）是目前药理学上降低总血浆胆固醇水平最有效的方法。多项多中心研究表明，与安慰剂相比，服用他汀类药物数年可显著降低心血管事件和死亡率。除了众所周知的降低低密度脂蛋白和胆固醇的作用外，他汀类药物还被认为由于所谓的“非脂质效应”而对死亡率产生有益影响。多项实验研究的间接证据表明，他汀类药物可改善内皮功能，发挥抗炎和抗氧化作用，稳定动脉粥样硬化斑块，并抑制平滑肌细胞的增殖和活化。然而，这些有益的“非脂质效应”的临床意义尚不清楚，但与他汀类药物对总血浆胆固醇水平的降低作用相比，似乎只起次要作用。
