比较瑞舒伐他汀单药治疗和阿托伐他汀-依折麦布联合治疗对冠心病患者红细胞膜结构的影响。

Comparison of the effects of rosuvastatin monotherapy and atorvastatin-ezetimibe combined therapy on the structure of erythrocyte membranes in patients with coronary artery disease.

机构信息

Department of Internal Diseases and Clinical Pharmacology, Medical University of Łódź, Łódź, Poland.

出版信息

Pharmacol Rep. 2018 Apr;70(2):258-262. doi: 10.1016/j.pharep.2017.11.004. Epub 2017 Nov 20.

DOI:10.1016/j.pharep.2017.11.004

PMID:29475008

Abstract

BACKGROUND

Abnormalities in the physical properties of the red blood cells (RBCs) membranes may underlie the defects that are strongly linked to cardiovascular diseases (CVD). The aim of the study was to compare the effects of two therapies of equal hipolipemic efficacy on the erythrocyte membrane fluidity, concentration of membrane cholesterol, lipids peroxidation and RBCs distribution witdh in patients with CVD.

METHODS

The study included 44 patients with angiographic evidence of CVD, who despite previous 6-month hypolipemic therapy, did not achieve the concentration of LDL-C <70mg/dl. They were randomly assigned to: rosuvastatin 20mg/day (R20) and atorvastatin 10mg/day combined with ezetimibe 10mg/day (A10+E10). The membrane fluidity, the concentration of thiobarbituric acid reactive substances -TBARS, concentration of membrane cholesterol were evaluated after 6 months therapy.

RESULTS

An improvement in lipid parameters was observed in each of the groups studied. In R20 the treatment resulted in 33% reduction concentrations of TBARS in serum, as well as in a decrease in membrane cholesterol by 16%, fluorescence anisotropy of TMA-DPH by 17.7%, fluorescence anisotropy of DPH by 2.8%. In A10+E10 the reduction of TBARS by 20.5% in serum, membrane cholesterol by 15.8% as well as a 14.25% increase in RBC membrane fluidity in the superficial layer (TMA-DPH) and decrease fluidity in the deep layer (DPH) were observed.

CONCLUSION

Rosuvastatin increases the fluidity of erythrocyte membrane and decreases the TBARS in serum to greater extent than does equal hipolipemic combined therapy atorvastatin with ezetimibe.

摘要

背景

红细胞（RBC）膜物理性质的异常可能是与心血管疾病（CVD）密切相关的缺陷的基础。本研究的目的是比较两种降脂疗效相当的治疗方法对 CVD 患者红细胞膜流动性、膜胆固醇浓度、脂质过氧化和红细胞分布宽度的影响。

方法

本研究纳入了 44 名经血管造影证实的 CVD 患者，尽管他们在之前的 6 个月降脂治疗中，未能将 LDL-C 浓度降至<70mg/dl。他们被随机分为两组：每天服用瑞舒伐他汀 20mg（R20）和阿托伐他汀 10mg 联合依折麦布 10mg（A10+E10）。治疗 6 个月后评估膜流动性、血清中硫代巴比妥酸反应物质（TBARS）浓度、膜胆固醇浓度。

结果

在每个研究组中都观察到了脂质参数的改善。在 R20 组中，治疗导致血清中 TBARS 浓度降低了 33%，同时膜胆固醇降低了 16%，TMA-DPH 的荧光各向异性降低了 17.7%，DPH 的荧光各向异性降低了 2.8%。在 A10+E10 组中，血清中 TBARS 降低了 20.5%，膜胆固醇降低了 15.8%，红细胞膜浅层（TMA-DPH）的流动性增加了 14.25%，深层（DPH）的流动性降低了。