Rylance P B, Gordge M P, Saynor R, Parsons V, Weston M J
Nephron. 1986;43(3):196-202. doi: 10.1159/000183829.
Haemodialysis patients have an exceptionally high incidence of death from cardiovascular causes, related in part to abnormalities of lipids and platelets. Eskimos, however, have a low incidence of myocardial infarction and have a high dietary intake of fish, rich in omega-3 polyunsaturated fatty acids. We have, therefore, studied the effect of a fish oil MaxEPA, containing 3.6 g of the omega-3 polyunsaturated fatty acid eicosapentaenoic acid on lipids and platelet function in haemodialysis patients. Following 8 weeks of therapy there was a 35% fall in triglycerides, a 10% rise of high-density lipoprotein (HDL) cholesterol, a 36% rise of HDL2 cholesterol fraction and a 54% rise of the HDL2:HDL3 cholesterol ratio. The platelet aggregation to adenosine diphosphate and collagen was significantly reduced. The activated whole-blood clotting time was prolonged from 141 to 153 s, and 69% of patients showed a reduction of factor VIII related antigen which is usually elevated in haemodialysis patients and is thought to be a marker of endothelial damage. The blood pressure fell from 147/82 to 124/74. We have thus shown that a dietary supplement of eicosapentaenoic acid produces potentially beneficial effects on lipids, platelets, and blood pressure and may help to protect against atheroma and thus cardiovascular mortality in high-risk haemodialysis patients.
血液透析患者因心血管原因死亡的发生率异常高，部分原因与脂质和血小板异常有关。然而，爱斯基摩人心肌梗死的发生率较低，且他们饮食中鱼类摄入量较高，而鱼类富含ω-3多不饱和脂肪酸。因此，我们研究了一种含3.6克ω-3多不饱和脂肪酸二十碳五烯酸的鱼油MaxEPA对血液透析患者脂质和血小板功能的影响。经过8周治疗后，甘油三酯下降了35%，高密度脂蛋白（HDL）胆固醇升高了10%，HDL2胆固醇组分升高了36%，HDL2:HDL3胆固醇比值升高了54%。血小板对二磷酸腺苷和胶原的聚集显著减少。活化全血凝固时间从141秒延长至153秒，69%的患者因子VIII相关抗原降低，而因子VIII相关抗原在血液透析患者中通常升高，被认为是内皮损伤的标志物。血压从147/82降至124/74。因此我们表明，补充二十碳五烯酸对脂质、血小板和血压产生了潜在的有益影响，可能有助于预防动脉粥样硬化，从而降低高危血液透析患者的心血管死亡率。
