辛伐他汀联合ω-3脂肪酸对混合性血脂异常患者高敏C反应蛋白、血脂异常及纤维蛋白溶解的影响。

Effects of simvastain combined with omega-3 fatty acids on high sensitive C-reactive protein, lipidemia, and fibrinolysis in patients with mixed dyslipidemia.

作者信息

Hong Heng, Xu Zhi-Min, Pang Bao-Sen, Cui Liang, Wei Yu, Guo Wen-Jing, Mao Yan-Ling, Yang Xin-Chun

机构信息

Heart Center, Beijing Chaoyang Hospital, Capital University of Medical Science, Beijing 100020.

出版信息

Chin Med Sci J. 2004 Jun;19(2):145-9.

PMID:15250255

Abstract

OBJECTIVE

To evaluate the effects of simvastatin combined with omega-3 fatty acids on high sensitive C-reactive protein (HsCRP), lipidemia, and fibrinolysis in coronary heart disease (CHD) and CHD risk equivalent patients with mixed dyslipidemia.

METHODS

A randomized, double-blind placebo controlled and parallel group trial was conducted. Patients with CHD and CHD risk equivalents with mixed dyslipidemia were treated with 10 or 20 mg simvastatin for 6-12 weeks. Following with the treatment of patients whose low-density lipoprotein cholesterol (LDL-ch) reaching goal level (< 100 mg/dL) or close to the goal (< 130 mg/dL), while triglyceride (TG) > or = 200 mg/dL and < 500 mg/dL, was combined with omega-3 fatty acids (3 g/d) or a placebo for 2 months. The effects of the treatment on HsCRP, total cholesterol (TC), LDL-ch, high-density lipoprotein cholesterol (HDL-ch), TG, lipoprotein (a) [LP (a)], apolipoprotein A1 (apoA1), apolipoprotein B (apoB), plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (tPA) were investigated. Forty patients finished the study with each group consisting of twenty patients.

RESULTS

(1) There were significant reductions of HsCRP, TG, TC, and TC/HDL-ch, which decreased by 2.16 +/- 2.77 mg/L (38.5%), 94.0 +/- 65.4 mg/dL (31.1%), 13.3 +/- 22.3 mg/dL (6.3%), 0.78 +/- 1.60 respectively in the omega-3 fatty acids group (P < 0.01, < 0.001, < 0.05, < 0.05) compared to the baseline. HsCRP and triglyceride reduction were more significant in omega-3 fatty acids group compared to the placebo group (P = 0.021 and 0.011 respectively). (2) In the omega-3 fatty acids group, the values and percentage of TG reduction had a significantly positive relation with HsCRP reduction (r = 0.51 and 0.45, P = 0.021 and 0.047 respectively).

CONCLUSION

In CHD and CHD risk equivalent patients with mixed dyslipidemia, dyslipidemia's therapeutic effect using simvastatin and omega-3 fatty acids may result from not only the combination of lipid adjustment, but also enhancement of their own nonlipid influences.

摘要

目的

评估辛伐他汀联合ω-3脂肪酸对冠心病（CHD）及CHD风险等同且伴有混合性血脂异常患者的高敏C反应蛋白（HsCRP）、血脂异常及纤维蛋白溶解功能的影响。

方法

进行一项随机、双盲、安慰剂对照的平行组试验。患有CHD及CHD风险等同且伴有混合性血脂异常的患者接受10或20mg辛伐他汀治疗6至12周。对于低密度脂蛋白胆固醇（LDL-ch）达到目标水平（<100mg/dL）或接近目标水平（<130mg/dL），而甘油三酯（TG）≥200mg/dL且<500mg/dL的患者，在后续治疗中联合ω-3脂肪酸（3g/d）或安慰剂治疗2个月。研究该治疗对HsCRP、总胆固醇（TC）、LDL-ch、高密度脂蛋白胆固醇（HDL-ch）、TG、脂蛋白（a）[LP（a）]、载脂蛋白A1（apoA1）、载脂蛋白B（apoB）、纤溶酶原激活物抑制剂-1（PAI-1）和组织纤溶酶原激活物（tPA）的影响。40例患者完成研究，每组20例。

结果

（1）ω-3脂肪酸组的HsCRP、TG、TC及TC/HDL-ch显著降低，与基线相比分别下降2.16±2.77mg/L（38.5%）、94.0±65.4mg/dL（31.1%）、13.3±22.3mg/dL（6.3%）、0.78±1.60（P<0.01、<0.001、<0.05、<0.05）。与安慰剂组相比，ω-3脂肪酸组的HsCRP和甘油三酯降低更显著（分别为P=0.021和0.011）。（2）在ω-3脂肪酸组中，TG降低值及降低百分比与HsCRP降低显著正相关（r分别为0.51和0.45，P分别为0.021和0.047）。