Okamoto S, Nakano K, Kosahara K, Kishinaka M, Oda H, Ichimiya H, Chijiiwa K, Kuroki S
First Department of Surgery, Kyushu University Faculty of Medicine, Fukuoka, Japan.
J Gastroenterol. 1994 Feb;29(1):47-55. doi: 10.1007/BF01229073.
To investigate the effects of pravastatin and ursodeoxycholic acid (UDCA) on cholesterol and bile acid metabolism in humans, 41 patients with cholesterol gallstone disease were allocated to four groups and treated with pravastatin (20 mg/day), UDCA (600 mg/day), both pravastatin and UDCA, or neither drug (control) for 1-2 weeks prior to elective cholecystectomy. Cholesterol 7 alpha-hydroxylase activity and serum levels of total 7 alpha-hydroxycholesterol were significantly increased by pravastatin and unaffected by UDCA. 3-Hydroxy-3-methylglutaryl coenzyme A reductase activity was markedly increased by pravastatin and decreased by UDCA. UDCA significantly decreased biliary cholesterol concentration and the cholesterol saturation index and prolonged the nucleation time; however, pravastatin alone had little effect on biliary lithogenicity. Serum total and low-density lipoprotein (LDL)-cholesterol levels were reduced most by the combined administration of pravastatin and UDCA. In conclusion, at a dose of 20 mg/day, pravastatin increased bile acid synthesis but did not decrease biliary lithogenicity. UDCA had no significant effect on bile acid synthesis, but markedly decreased biliary lithogenicity.
为研究普伐他汀和熊去氧胆酸（UDCA）对人体胆固醇及胆汁酸代谢的影响，41例胆固醇结石病患者被分为四组，在择期胆囊切除术前行1 - 2周的治疗，分别给予普伐他汀（20毫克/天）、UDCA（600毫克/天）、普伐他汀与UDCA联合用药或不用药（对照组）。普伐他汀可显著提高胆固醇7α - 羟化酶活性及血清总7α - 羟基胆固醇水平，而UDCA对其无影响。普伐他汀可显著提高3 - 羟基 - 3 - 甲基戊二酰辅酶A还原酶活性，UDCA则降低该酶活性。UDCA可显著降低胆汁胆固醇浓度及胆固醇饱和指数，并延长成核时间；然而，单独使用普伐他汀对胆汁致石性影响不大。普伐他汀与UDCA联合应用时，血清总胆固醇及低密度脂蛋白（LDL）胆固醇水平降低最为明显。总之，每日剂量为20毫克时，普伐他汀可增加胆汁酸合成，但不降低胆汁致石性。UDCA对胆汁酸合成无显著影响，但可显著降低胆汁致石性。
