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ω-3多不饱和脂肪酸对心肌梗死后患者血浆血栓形成和炎症指标的影响。

Effects of omega-3 polyunsaturated fatty acids on plasma indices of thrombogenesis and inflammation in patients post-myocardial infarction.

作者信息

Lee Kaeng W, Blann Andrew D, Lip Gregory Y H

机构信息

Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.

出版信息

Thromb Res. 2006;118(3):305-12. doi: 10.1016/j.thromres.2005.07.018. Epub 2005 Sep 8.

Abstract

OBJECTIVE

To determine the effects of n-3 PUFAs supplementation on plasma indices of coagulation (fibrinogen), fibrin D-Dimer (an index of thrombogenesis and fibrin turnover), endothelial damage/dysfunction (von Willebrand factor (vWf)), platelet activation (soluble P-selectin (sP-sel)) and inflammation (interleukin-6, IL-6) in patients following acute myocardial infarction.

METHODS

Open-labelled randomised controlled trial. Seventy-seven post-myocardial infarction (MI) patients stabilized on standard secondary prevention therapy were randomised either to 3 months' treatment with Omacor 1 g/day (n=37) or 'usual care' control (n=40). Plasma levels of fibrinogen, D-Dimer, vWf, sP-sel, IL-6 and plasma viscosity at baseline and after 3 months were determined.

RESULTS

At baseline, there were no significant differences between the groups in all research indices, except vWf levels were higher in patients allocated to Omacor supplementation. After 3 months, there were no significant changes in the levels of any research indices in either the Omacor supplemented or the 'usual care' control patients when compared to baseline. Patients who received Omacor experienced a fall in total cholesterol (p=0.019), total/HDL-cholesterol ratio (p=0.009) and LDL-cholesterol (p=0.023). However, the relative changes in plasma lipids and lipoproteins did not differ between the two groups.

CONCLUSIONS

Three-month supplementation of Omacor at 1 g per day in post-MI patients is not associated with an improvement in the levels of peripheral indices of coagulation potential, endothelial function, platelet reactivity and inflammation.

摘要

目的

确定补充n-3多不饱和脂肪酸(PUFAs)对急性心肌梗死后患者血浆凝血指标(纤维蛋白原)、纤维蛋白D-二聚体(血栓形成和纤维蛋白周转指标)、内皮损伤/功能障碍(血管性血友病因子(vWf))、血小板活化(可溶性P-选择素(sP-sel))及炎症(白细胞介素-6,IL-6)的影响。

方法

开放标签随机对照试验。77例接受标准二级预防治疗病情稳定的心肌梗死(MI)后患者被随机分为两组,一组接受每天1g Omacor治疗3个月(n = 37),另一组接受“常规护理”对照(n = 40)。测定基线及3个月后血浆纤维蛋白原、D-二聚体、vWf、sP-sel、IL-6水平及血浆黏度。

结果

基线时,除分配至补充Omacor组的患者vWf水平较高外,两组所有研究指标均无显著差异。3个月后,与基线相比,补充Omacor组或“常规护理”对照组患者的任何研究指标水平均无显著变化。接受Omacor治疗的患者总胆固醇(p = 0.019)、总胆固醇/高密度脂蛋白胆固醇比值(p = 0.009)和低密度脂蛋白胆固醇(p = 0.023)下降。然而,两组血浆脂质和脂蛋白的相对变化无差异。

结论

心肌梗死后患者每天补充1g Omacor 3个月,与外周凝血潜能、内皮功能、血小板反应性及炎症指标水平的改善无关。

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