Connor S L, Connor W E
Department of Medicine, Oregon Health Sciences University, Portland 97201-3098, USA.
Am J Clin Nutr. 1997 Oct;66(4 Suppl):1020S-1031S. doi: 10.1093/ajcn/66.4.1020S.
The n-3 fatty acids of fish and fish oil have great potential for the prevention and treatment of patients with coronary artery disease. Unlike many of the pharmaceutical agents used in patients with coronary artery disease that have just a single mechanism of action, the eicosapentaenoic and docosahexaenoic acids of fish oil have multifaceted actions. One of their most important effects is the prevention of arrhythmias, with documentation derived from experiments in cultured myocytes, experiments in animals, epidemiologic correlations, and clinical trials. Especially important is the ability of these n-3 fatty acids to inhibit ventricular fibrillation and consequent cardiac arrest. Eicosapentaenoic acid has several antithrombotic actions, particularly in inhibiting the synthesis of thromboxane A2, the prostaglandin that causes platelet aggregation and vasoconstriction. Fish oil retards the growth of the atherosclerotic plaque by inhibiting both cellular growth factors and the migration of monocytes. The n-3 fatty acids promote the synthesis of the beneficial nitric oxide in the endothelium. Experiments in humans indicate a profound hypolipidemic effect of fish oil, especially lowering of plasma triacylglycerol. Both very-low-density lipoprotein production and apolipoprotein B synthesis are inhibited by fish oil. Finally, fish oil has a mild blood pressure-lowering effect in both normal and mildly hypertensive individuals. These composite effects suggest a prominent therapeutic role for fish oil in the prevention and treatment of coronary artery disease.
鱼类及鱼油中的n-3脂肪酸在冠状动脉疾病患者的预防和治疗方面具有巨大潜力。与许多用于冠状动脉疾病患者的仅有一种作用机制的药物不同，鱼油中的二十碳五烯酸和二十二碳六烯酸具有多方面的作用。它们最重要的作用之一是预防心律失常，这一点已从培养心肌细胞实验、动物实验、流行病学相关性研究及临床试验中得到证实。特别重要的是，这些n-3脂肪酸能够抑制心室颤动及随之而来的心脏骤停。二十碳五烯酸具有多种抗血栓形成作用，尤其能抑制血栓素A2的合成，血栓素A2是一种可导致血小板聚集和血管收缩的前列腺素。鱼油通过抑制细胞生长因子和单核细胞迁移来延缓动脉粥样硬化斑块的生长。n-3脂肪酸可促进内皮细胞中有益的一氧化氮的合成。人体实验表明鱼油具有显著的降血脂作用，尤其是能降低血浆甘油三酯水平。鱼油可抑制极低密度脂蛋白的产生及载脂蛋白B的合成。最后，鱼油对正常人和轻度高血压患者均有轻度的降压作用。这些综合作用表明鱼油在冠状动脉疾病的预防和治疗中具有重要的治疗作用。
