Johansson J O, Egberg N, Asplund-Carlson A, Carlson L A
Research Centre of General Medicine, NVSO, Karolinska Hospital, Stockholm, Sweden.
J Cardiovasc Risk. 1997 Jun;4(3):165-71.
Nicotinic acid in gram doses decreases cholesterol and triglyceride concentrations in plasma, but the effect on haemostatic function is not known.
Twenty-three men with hypertriglyceridaemia were treated with 4 g nicotinic acid daily for 6 weeks. Tests for haemostatic function and serum lipoproteins were performed before and at the end of the period of treatment.
Treatment with nicotinic acid had the expected effect on lipoprotein concentrations: it reduced the serum concentrations of triglyceride and the three major density fractions of triglyceride (very low density lipoprotein (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL)). The VLDL cholesterol concentration was reduced, but that of HDL cholesterol was increased (all P<0.0001). The lipoprotein(a) (Lp(a)) concentration decreased significantly (P<0.01). The total fibrinolytic activity was increased by nicotinic acid treatment as indicated by decreases in plasminogen activator inhibitor-1 activity from 34.3 to 23.8 U/ml (P<0.01) and in alpha2-antiplasmin activity from 1.10 to 0.97 U/ml (P<0.01). The plasma fibrinogen concentration decreased from 3.55 to 3.01 U/ml (P<0.01). Multvariate analysis showed that the changes in alpha2-antiplasmin and Lp(a) concentrations could explain 53% of the change in plasma fibrinogen, suggesting that increased plasmin mobilization could be responsible for the decrease in plasma fibrinogen.
This study of hypertriglyceridaemic men has shown that long-term treatment with nicotinic acid not only corrects serum lipoprotein abnormalities, but also reduces the fibrinogen concentration in plasma and stimulates fibrinolysis.
克剂量的烟酸可降低血浆中的胆固醇和甘油三酯浓度，但对止血功能的影响尚不清楚。
23名高甘油三酯血症男性患者每天服用4克烟酸，持续6周。在治疗期开始前和结束时进行止血功能和血清脂蛋白检测。
烟酸治疗对脂蛋白浓度产生了预期效果：它降低了甘油三酯的血清浓度以及甘油三酯的三个主要密度组分（极低密度脂蛋白（VLDL）、低密度脂蛋白（LDL）和高密度脂蛋白（HDL））。VLDL胆固醇浓度降低，但HDL胆固醇浓度升高（所有P<0.0001）。脂蛋白(a)（Lp(a)）浓度显著降低（P<0.01）。烟酸治疗使总纤溶活性增加，表现为纤溶酶原激活物抑制剂-1活性从34.3降至23.8 U/ml（P<0.01），α2-抗纤溶酶活性从1.10降至0.97 U/ml（P<0.01）。血浆纤维蛋白原浓度从3.55降至3.01 U/ml（P<0.01）。多变量分析表明，α2-抗纤溶酶和Lp(a)浓度的变化可解释血浆纤维蛋白原变化的53%，提示纤溶酶动员增加可能是血浆纤维蛋白原降低的原因。
这项对高甘油三酯血症男性的研究表明，长期使用烟酸治疗不仅可纠正血清脂蛋白异常，还可降低血浆纤维蛋白原浓度并刺激纤溶。
