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ω-3 多不饱和脂肪酸对健康受试者和心血管疾病患者血小板功能的影响。

Effects of omega-3 polyunsaturated fatty acids on platelet function in healthy subjects and subjects with cardiovascular disease.

机构信息

Northern Blood Research Centre, Kolling Institute of Medical Research, University of Sydney, New South Wales, Australia.

出版信息

Semin Thromb Hemost. 2013 Feb;39(1):25-32. doi: 10.1055/s-0032-1333309. Epub 2013 Jan 17.

Abstract

Hyperactivation and aggregation of platelets play a major role in thrombosis and hemostasis. The aims of this study were to investigate the effects of omega-3 polyunsaturated fatty acids (PUFAs) on platelet function. Light transmission aggregometry and flow cytometric analyses of platelet activation and platelet-leukocyte aggregates were determined at baseline and after 4 weeks of omega-3 (docosahexaenoic acid 520 mg and eicosapentaenoic acid 120 mg) supplementation. In total, 40 healthy subjects and 16 patients with a history of cardiovascular disease (CVD) completed the study. In healthy subjects, omega-3 PUFA significantly reduced adenosine diphosphate (ADP)-induced (maximum amplitude, 77.0% ± 3.2% vs. 71.6% ± 3.4%, p = 0.036; maximum slope, 86.3 ± 1.8 vs. 80.7 ± 2.1, p = 0.014) and adrenaline-induced platelet aggregation (maximum slope, 42.8 ± 2.7 vs. 37.4 ± 3.0, p = 0.013; lag time, 00:21 ± 00:02 vs. 00:31 ± 00:03 s, p = 0.002). Omega-3 PUFA also reduced P-selectin expression (40.5% ± 2.9% vs. 34.4% ± 2.4%, p = 0.049) on platelets and platelet-monocyte aggregates (38.5% ± 2.6% vs. 31.4% ± 2.5%, p = 0.022) after activation with ADP 0.5 µM. There were fewer changes in platelet aggregation and activation found in subjects with CVD. Nevertheless, there was a reduction in the slope of arachidonic acid-induced platelet aggregation (13.21 ± 6.41 vs. 4.88 ± 3.01, p = 0.009) and increased lag time for U46619 (00:16 ± 00:00 vs. 00:29 ± 00:07 s, p = 0.018) induced platelet aggregation. Thus, 4-week supplementation of 640 mg omega-3 PUFA reduced measures of platelet aggregation and activation in healthy subjects but effects were less evident in patients with existing CVD. Our findings support the recommendation that the omega-3 PUFA dose be higher in CVD than among healthy subjects.

摘要

血小板的过度激活和聚集在血栓形成和止血中起着重要作用。本研究旨在探讨ω-3 多不饱和脂肪酸(PUFA)对血小板功能的影响。在基线和补充 ω-3(二十二碳六烯酸 520mg 和二十碳五烯酸 120mg)4 周后,通过透光比浊法和流式细胞术分析血小板激活和血小板-白细胞聚集体。共有 40 名健康受试者和 16 名有心血管疾病(CVD)病史的患者完成了这项研究。在健康受试者中,ω-3 PUFA 显著降低了二磷酸腺苷(ADP)诱导的(最大幅度,77.0%±3.2% vs. 71.6%±3.4%,p=0.036;最大斜率,86.3±1.8 vs. 80.7±2.1,p=0.014)和肾上腺素诱导的血小板聚集(最大斜率,42.8±2.7 vs. 37.4±3.0,p=0.013;lag time,00:21±00:02 vs. 00:31±00:03 s,p=0.002)。ω-3 PUFA 还降低了 ADP 0.5µM 激活后血小板上的 P-选择素表达(40.5%±2.9% vs. 34.4%±2.4%,p=0.049)和血小板-单核细胞聚集体(38.5%±2.6% vs. 31.4%±2.5%,p=0.022)。在患有 CVD 的受试者中,血小板聚集和激活的变化较少。然而,花生四烯酸诱导的血小板聚集斜率降低(13.21±6.41 vs. 4.88±3.01,p=0.009),U46619 诱导的血小板聚集的 lag time 增加(00:16±00:00 vs. 00:29±00:07 s,p=0.018)。因此,4 周补充 640mg ω-3 PUFA 降低了健康受试者的血小板聚集和激活指标,但在已有 CVD 的患者中效果不明显。我们的发现支持这样的建议,即 ω-3 PUFA 的剂量在 CVD 患者中应高于健康受试者。

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