Mol M J, Stuyt P M, Demacker P N, Stalenhoef A F
Department of Medicine, University Hospital, Nijmegen.
Neth J Med. 1990 Apr;36(3-4):182-90.
The effects of simvastatin, an inhibitor of cholesterol synthesis, on serum lipids, lipoprotein composition and apolipoproteins were evaluated in a total of 50 patients with hypercholesterolaemia. In the first study, 24 patients (mean serum cholesterol 10.74 +/- 1.59 mmol/l) were treated with simvastatin 40 mg daily for 24 wk. Serum cholesterol and low density lipoprotein (LDL) cholesterol decreased to average values 29-36% and 35-42% below the basal value, respectively. Serum triglycerides decreased by 16-28%, and high density lipoprotein (HDL) cholesterol increased by 6-11%. Apolipoprotein A-I concentration increased 6-8% and that of apolipoprotein B decreased 29-33%. The composition of LDL remained unchanged whereas the very low density lipoproteins became enriched in triglycerides. Lipoprotein Lp(a) was not affected. In the second study 26 patients (mean serum cholesterol 12.35 +/- 2.05 mmol/l) were treated with simvastatin 40 mg daily as monotherapy or combined with a bile acid binding resin for 2 yr. Serum cholesterol levels decreased to values which remained stable throughout the entire study period; after 2 yr this decrease amounted to 43%. Compared to monotherapy, combination therapy yielded a further 12% decrease of cholesterol. In the entire group, triglycerides decreased by 16% and HDL cholesterol increased by 9%. Side effects were limited to slight increases in alanine aminotransferase and creatine phosphokinase in some patients. Simvastatin appears to be an important asset in the treatment of hypercholesterolaemia.
在总共50例高胆固醇血症患者中评估了胆固醇合成抑制剂辛伐他汀对血脂、脂蛋白组成和载脂蛋白的影响。在第一项研究中，24例患者（平均血清胆固醇10.74±1.59 mmol/L）每日服用40 mg辛伐他汀，持续24周。血清胆固醇和低密度脂蛋白（LDL）胆固醇分别降至比基础值低29 - 36%和35 - 42%的平均值。血清甘油三酯下降了16 - 28%，高密度脂蛋白（HDL）胆固醇升高了6 - 11%。载脂蛋白A - I浓度升高了6 - 8%，载脂蛋白B浓度下降了29 - 33%。LDL的组成保持不变，而极低密度脂蛋白的甘油三酯含量增加。脂蛋白Lp(a)未受影响。在第二项研究中，26例患者（平均血清胆固醇12.35±2.05 mmol/L）每日服用40 mg辛伐他汀作为单一疗法或与胆汁酸结合树脂联合使用，持续2年。血清胆固醇水平降至在整个研究期间保持稳定的值；2年后，这种下降幅度达43%。与单一疗法相比，联合疗法使胆固醇进一步降低了12%。在整个组中，甘油三酯下降了16%，HDL胆固醇升高了9%。副作用仅限于一些患者的丙氨酸转氨酶和肌酸磷酸激酶略有升高。辛伐他汀似乎是治疗高胆固醇血症的一项重要药物。
