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处方型ω-3 酸乙酯联合辛伐他汀 20 和 80 毫克:混合性血脂异常的疗效。

Prescription omega-3 acid ethyl esters plus simvastatin 20 and 80 mg: effects in mixed dyslipidemia.

机构信息

Provident Clinical Research, 489 Taft Avenue, Glen Ellyn, IL 60137 USA.

出版信息

J Clin Lipidol. 2009 Feb;3(1):33-8. doi: 10.1016/j.jacl.2008.12.007. Epub 2008 Dec 27.

DOI:10.1016/j.jacl.2008.12.007
PMID:21291786
Abstract

BACKGROUND

Prescription omega-3 acid ethyl esters (P-OM3) plus simvastatin 20 and 40 mg/day improves lipids in subjects with mixed dyslipidemia, but no previous studies have examined P-OM3 with the maximum prescribed dose of simvastatin (80 mg).

OBJECTIVE

To assess the effects of P-OM3 + simvastatin 80 mg versus P-OM3 + simvastatin 20 mg or placebo + simvastatin 20 mg on non-high-density lipoprotein cholesterol (non-HDL-C) and other lipid concentrations.

METHODS

Subjects with mixed dyslipidemia who had completed a 12-week double-blind crossover study of simvastatin 20 mg/day + either placebo or P-OM3 4 g/day were enrolled. An analysis (n = 14) was performed following the first six weeks of the extension, during which all subjects received open-label P-OM3 + open-label simvastatin 80 mg/day.

RESULTS

P-OM3 + simvastatin 80 mg resulted in significantly larger reductions from baseline (P < .05 for all) versus P-OM3 + simvastatin 20 mg and placebo + simvastatin 20 mg, respectively, for non-HDL-C (-51.0%, -40.8%, -34.9%), low-density lipoprotein cholesterol (-48.0%, -35.5%, -38.0%), total cholesterol (TC) (-42.6%, -31.9%, -27.1%), the TC/HDL-C ratio (-52.9%, -44.3%, -36.2%), and apolipoprotein B (-42.6%, -32.6%, -30.5%). P-OM3 + simvastatin (80- and 20-mg doses, respectively) resulted in significantly larger changes from baseline (P < .05 for all) versus placebo in very low-density lipoprotein cholesterol (-50.7%, -47.9%, -23.0%), triglycerides (TG; -58.6%, -54.7%, -32.0%), HDL-C (24.5%, 20.7%, 17.9%), and the TG/HDL-C ratio (-66.5%, -62.3%, -42.5%).

CONCLUSION

These results suggest non-HDL-C, TG (both 50% to 60%), and HDL-C (∼25%) concentrations can be markedly improved by a combination of P-OM3 (4 g/day) and simvastatin (80 mg/day) in subjects with mixed dyslipidemia.

摘要

背景

处方ω-3 酸乙酯(P-OM3)联合辛伐他汀 20 毫克和 40 毫克/天可改善混合性血脂异常患者的血脂,但尚无研究探讨 P-OM3 联合最大推荐剂量的辛伐他汀(80 毫克)。

目的

评估 P-OM3+辛伐他汀 80 毫克与 P-OM3+辛伐他汀 20 毫克或安慰剂+辛伐他汀 20 毫克对非高密度脂蛋白胆固醇(非-HDL-C)和其他血脂浓度的影响。

方法

完成辛伐他汀 20 毫克/天+安慰剂或 P-OM3 4 克/天双盲交叉研究的混合性血脂异常患者入组本扩展研究。在扩展研究的前 6 周(所有患者接受开放标签 P-OM3+开放标签辛伐他汀 80 毫克/天)后进行分析(n=14)。

结果

与 P-OM3+辛伐他汀 20 毫克和安慰剂+辛伐他汀 20 毫克相比,P-OM3+辛伐他汀 80 毫克分别使非-HDL-C(-51.0%、-40.8%、-34.9%)、低密度脂蛋白胆固醇(-48.0%、-35.5%、-38.0%)、总胆固醇(TC)(-42.6%、-31.9%、-27.1%)、TC/高密度脂蛋白胆固醇(HDL-C)比值(-52.9%、-44.3%、-36.2%)和载脂蛋白 B(-42.6%、-32.6%、-30.5%)显著降低,差异均有统计学意义(P均<.05)。与安慰剂相比,P-OM3+辛伐他汀(80 毫克和 20 毫克剂量)使极低密度脂蛋白胆固醇(-50.7%、-47.9%、-23.0%)、甘油三酯(TG;-58.6%、-54.7%、-32.0%)、HDL-C(24.5%、20.7%、17.9%)和 TG/HDL-C 比值(-66.5%、-62.3%、-42.5%)显著降低,差异均有统计学意义(P均<.05)。

结论

这些结果提示,在混合性血脂异常患者中,P-OM3(4 克/天)联合辛伐他汀(80 毫克/天)可使非-HDL-C、TG(50%~60%)和 HDL-C(约 25%)浓度显著改善。

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