Broyles F E, Walden C E, Hunninghake D B, Hill-Williams D, Knopp R H
Northwest Lipid Research Clinic, University of Washington School of Medicine, Seattle 98104, USA.
Am J Cardiol. 1995 Jul 13;76(2):129A-135A. doi: 10.1016/s0002-9149(05)80035-9.
The accelerated atherosclerosis in diseases associated with elevated remnant lipoprotein levels has directed interest toward the response of this lipoprotein species to lipid-lowering treatment. The effect of fluvastatin--a synthetic 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor--was compared with that of placebo on parameters of remnant metabolism in 57 patients with moderate hypercholesterolemia, but not heterozygous familial hypercholesterolemia, type III hyperlipidemia, or endogenous hypertriglyceridemia. Fluvastatin therapy resulted in decreases versus baseline in plasma total cholesterol, low density lipoprotein cholesterol (LDL-C) and LDL apolipoprotein (apo) B levels of 18%, 20%, and 18%, respectively (p < 0.01). Plasma parameters related to remnant metabolism were also significantly decreased: intermediate density lipoprotein by 43% and apo E by 22% (p < 0.01). The percent decrease in plasma intermediate density lipoprotein cholesterol level was twice that of LDL-C and 50% greater than the decrease seen in very low density lipoprotein cholesterol (VLDL-C), which was decreased by 28%. Total triglycerides were reduced by 11% and VLDL apo B by 24%, whereas high density lipoprotein cholesterol (HDL-C) rose significantly by 8%, HDL2-C by 24%, and HDL3-C by 3%. There were no increases in apo A-I levels compared with placebo nor any significant change in plasma lipoprotein(a) levels. The composition of LDL and VLDL particles did not appear to be altered by therapy, as assessed by the LDL-C:LDL-B, VLDL-C:VLDL-B, or triglyceride:VLDL-B ratios.(ABSTRACT TRUNCATED AT 250 WORDS)
在与残余脂蛋白水平升高相关的疾病中，动脉粥样硬化加速，这使得人们将兴趣转向了这种脂蛋白对降脂治疗的反应。在57例中度高胆固醇血症患者（但不包括杂合子家族性高胆固醇血症、III型高脂血症或内源性高甘油三酯血症患者）中，比较了氟伐他汀（一种合成的3-羟基-3-甲基戊二酰辅酶A（HMG-CoA）还原酶抑制剂）与安慰剂对残余代谢参数的影响。氟伐他汀治疗导致血浆总胆固醇、低密度脂蛋白胆固醇（LDL-C）和LDL载脂蛋白（apo）B水平相对于基线分别降低了18%、20%和18%（p<0.01）。与残余代谢相关的血浆参数也显著降低：中密度脂蛋白降低43%，apo E降低22%（p<0.01）。血浆中密度脂蛋白胆固醇水平的降低百分比是LDL-C的两倍，比极低密度脂蛋白胆固醇（VLDL-C）降低的幅度高50%，VLDL-C降低了28%。总甘油三酯降低了11%，VLDL apo B降低了24%，而高密度脂蛋白胆固醇（HDL-C）显著升高了8%，HDL2-C升高了24%，HDL3-C升高了3%。与安慰剂相比，apo A-I水平没有升高，血浆脂蛋白(a)水平也没有显著变化。通过LDL-C:LDL-B、VLDL-C:VLDL-B或甘油三酯:VLDL-B比值评估，治疗似乎未改变LDL和VLDL颗粒的组成。（摘要截断于250字）
